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Cystic Fibrosis Care Center

Treatment Options

Positive Expiratory Pressure

Positive Expiratory Pressure uses a small device that the patient exhales into using a mask. PEP is also called PEP Therapy, PEP Mask or TheraPEP. The PEP device creates pressure in the lungs and keeps airways from closing. Air flowing through the PEP device helps move the mucus into the larger airway. A huff cough helps move the mucus out of the airways.

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Using the PEP Device

Following these steps when using the PEP device:
  1. Sit up straight with your elbows resting on a table
  2. Take slightly deeper breaths than normal for 1-2 minutes
  3. Take a large, steady breath (just slightly more than a normal breath) through the mask attached to the PEP
  4. Hold your breath for 2-3 seconds
  5. Breathe out through the mask into the PEP device to create pressure 10-20 cm H2O. Breathe out for 4-5 seconds until just beyond a normal breath
  6. Repeat 15 times (one cycle). Keep the mask sealed around your mouth and nose throughout the cycle
  7. At the end of the cycle, remove the mask and perform two to three huff coughs
  8. Follow this with one regular cough (or more) to clear the mucus from the large airways
  9. Rest for one to two minutes while you do a controlled breathing exercise
  10. Repeat the entire process for six cycles or a maximum of 30 minutes

Cleaning the PEP Device

After each treatment, store the device on a clean paper towel to air-dry. You should not rinse or disinfect the white tubing or the white/blue pressure manometer cone. The outside of the manometer can be wiped down but should not be taken apart or placed in water.

Every day, you should clean the device with mild soap and rinse it with sterile water. Then air-dry it on a clean paper towel and disinfect it.

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