Positive expiratory pressure involves breathing against an airway resistance provided by a flute-like device. This approach has been used for lung training and to open and clear airways. This intervention, along with patient self-monitoring of forced expiratory volume in 1 second (FEV1), was evaluated for its effect on the development of pneumonia in high-risk patients with cancer. FEV1 monitoring was used for early detection of pulmonary deterioration, enabling early diagnostic testing and interventions as needed.
Moller, T., Moser, C., Adamsen, L., Rugaard, G., Jarden, M., Botcher, T.S., . . . Kjeldsen, L. (2016). Early warning and prevention of pneumonia in acute leukemia by patient education, spirometry, and positive expiratory pressure: A randomized controlled trial. American Journal of Hematology, 91, 271–276.
To evaluate the feasibility and effectiveness of a patient-performed daily spirometry as an early warning tool and the use of a positive expiratory pressure (PEP) flute device to prevent pneumonia among outpatients undergoing treatment for acute myeloid leukemia (AML)
All patients received a 45-minute face-to-face educational session about pneumonia prevention and assessing for early signs, plus instructions on how to use a spirometer and record findings daily. The intervention group received PEP flutes and instructions for use. All patients received instructions for contacting a healthcare provider if symptoms occurred. The primary outcome was occurrences of pneumonia.
The use of FEV1 to monitor for early onset pneumonia can be effective. The use of the PEP flute significantly decreases the occurrence of pneumonia.
Direct patient education on the use of spirometry to evaluate FEV1 and PEP flutes is effective. FEV1 findings can potentially aid with early pneumonia diagnosis, and the use of the PEP flutes can help prevent pneumonia.