What is PEP?

Studies have shown that Positive Expiratory Pressure (PEP) by using an acapella, along with medicated aerosols, may help patients with asthma, COPD and cystic fibrosis clear secretions from their airway.
Inhaled medicines have the following effect:

1. Promote hydration
2. Reduce secretion viscosity
3. Optimize mucociliary clearance 

PEP therapy has the following effect:

Improve collateral ventilation to allow better distribution of gas beyond occluded airways

PEP works by creating a positive pressure to splint open and stabilize airways, preventing bronchial collapse. So when a treatment is given in conjunction with a nebulizer, it may result in better distribution of the medicine while enhancing secretion clearance.

Reference:

1. Mesquita, Fabricio, et al., "Scintigraphic Assessment of radio-Aerosol Pulmonary Deposition With the Acapella Positive Expiratory Pressure Device and Varoius Nebulizer Configurations," Respiratory Care, March, 2014, volume 59, number 3, pages 328-333

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