One in 10 adults suffers from the debilitating effects of chronic obstructive pulmonary disease (COPD). Research on a new respirator developed by pulmonologists at the University of Cincinnati promises to improve lives.
Not only does the new device improve symptoms of shortness of breath and quality of life for people with COPD, but it also offers benefits for people dealing with stress and anxiety and those who practice mindfulness, meditation, or yoga.
Publication of the research in the journal respiratory care.
The device, called PEP Buddy, was created by Muhammad Ahsan Zafar, MD, and Ralph Banus, MD. Dhofar is an associate professor in the division of pulmonary critical care and sleep medicine at the University of California School of Medicine, while Panos serves as a professor emeritus of pulmonary and critical care at the University of California School of Medicine and director of the National Telemedicine ICU Program for U.S. Veterans Affairs.
“Dr. Panos and I see patients with COPD, which is a huge population,” says Zafar. “Their lives really change when they have COPD. They were such active individuals but now they’re vulnerable and limited, so we wanted to come up with something easy that would help them improve their lives.”
For people with COPD, it takes longer to breathe air out of their lungs with each breath because the air tubes are narrowed. Therefore, when they breathe rapidly, such as during physical activities, air is retained in the lungs. This air build-up or “hyperdynamic inflation” is the main cause of shortness of breath and also leads to low oxygen levels. With difficulty breathing during physical activity, people become less active, less active, and more isolated.
Panos and Zafar developed a whistle-sized hands-free device. Zafar said he looked at positive expiratory pressure (PEP) respirators on the market and they were handheld, big and bulky, so they tried to create something very simple, lightweight and easy to use. The device is designed to be worn around the neck with a lanyard for daily use and inserted into the mouth when needed, during or after exertion.
In the study, they examined people with COPD who had shortness of breath and gave them two tasks. “We did a six-minute walking test with and without the device,” says Zafar. “They were given the device to take home and use in their daily routine. Within two weeks, there was a follow-up to see how use of the PEP Buddy affected their shortness of breath and quality of life.”
The study found that 72% of the participants had a significant impact in reducing their shortness of breath and improving their quality of life. Of those whose oxygen level dropped while walking, 36% did not drop their oxygen levels when using the PEP Buddy. This is the first mechanical device to show such an effect on oxygen levels in people with COPD.
Maja Flannery, a PEP Buddy user who suffers from chronic lung disease and airflow obstruction, says the device has changed her daily life.
“I’m so glad I was fortunate enough to be a part of the study and be able to use this great little device to breathe better,” says Flannery. “I use it when I get up in the morning. It helps with my air requirements when changing position from lying down to standing and it exercises my lungs to get them more prepared for the day. I find it helpful in letting out trapped air like I’m active, so I can play longer points during tennis, and also recover between points quickly.” Akbar… My tennis friends laugh at it as the “magic whistle.”
The next step in this research, Dhofar of UCLA says, is to conduct a long-term study to see the effect on rescue inhaler use, emergency department visits, long-term symptoms, and functional ability in people with COPD. PEP Buddy may also be a promising addition to pulmonary rehabilitation programs for faster improvement and maintenance of better outcomes. They are also exploring other uses for PEP Buddy in healthcare.
“As a doctor, I feel grateful that we are introducing something new that can really improve people’s lives,” says Zafar. “This is where my passion is. These people are really vulnerable because they don’t have many tools on their hands to improve their symptoms right now. PEP Buddy will be one of those tools.”
