Positive Expiratory Pressure Therapy Device, the Acapella in Post-ECMO Rehabilitation

Depending on the choice of cannulation techniques, ECMO can deliver purely respiratory support, respiratory support with right ventricular support, and full cardiopulmonary support. Today, with careful patient selection, ECMO is used as a rescue therapy to allow for recovery or bridge to transplant for hypoxic respiratory failure and severe refractory cardiogenic shock. The adverse effects of deep sedation and paralysis including bradycardia, ICU-acquired paresis, and ventilator-associated pneumonia pose valid concerns with reduction in lung volumes and capacities. One of the most frequently prescribed airway clearance therapy (ACT) options for patients with chronic lung conditions or decreased lung volumes is positive expiratory pressure therapy (PEP) device (Acapella) which causes reduction in hyperinflation and many other positive facts described in this review.