{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T18:48:14Z","timestamp":1774723694339,"version":"3.50.1"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,2,3]]},"abstract":"<jats:p>A 26-year-old, 14\u2005week pregnant woman was admitted to our hospital with pneumonia with acute respiratory distress syndrome in an intubated and mechanically ventilated state. She was diagnosed to have polymicrobial infection and left-sided pneumothorax and was put on a ventilator for 2\u2005weeks. Postextubation, she found it difficult to clear her respiratory secretions despite aggressive routine chest physiotherapy. She was planned to undergo a mini-tracheostomy for tracheobronchial toileting. However, before that, she was given a trial of Acapella, a hand-held oscillatory positive expiratory pressure (OPEP) therapy device, for facilitating airway clearance, with the aim to speed up the recovery. The patient found it easy to use and clear the secretions optimally, thus averting a mini-tracheostomy. This case report highlights the advantages of the OPEP therapy device in effective management of bronchial hygiene in patients with poor respiratory effort.<\/jats:p>","DOI":"10.1136\/bcr-2013-202598","type":"journal-article","created":{"date-parts":[[2015,6,18]],"date-time":"2015-06-18T16:09:24Z","timestamp":1434643764000},"page":"bcr2013202598","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Use of an oscillatory PEP device to enhance bronchial hygiene in a patient of post-H1NI pneumonia and acute respiratory distress syndrome with pneumothorax"],"prefix":"10.1136","volume":"2014","author":[{"given":"Deepali","family":"Narula","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Fortis Hospital, Vasant Kunj, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Nangia","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Fortis Hospital, Vasant Kunj, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,3,7]]},"reference":[{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.1","first-page":"516","article-title":"Use of positive airway pressure adjuncts to bronchial hygiene therapy","volume":"38","author":"AARC Clinical Practice Guidelines","year":"1993","journal-title":"Respir Care"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.4.7921452"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.3","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.114017"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.4","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.99.14614189"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.5","doi-asserted-by":"publisher","DOI":"10.1159\/000085363"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.6","first-page":"124","article-title":"Performance comparison of two oscillating positive expiratory pressure devices: Acapella versus Flutter","volume":"48","author":"Volsko","year":"2003","journal-title":"Respir Care"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.7","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950020608"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.8","first-page":"339","article-title":"Positive expiratory pressure (PEP-mask) physiotherapy improves ventilation and reduces volume of trapped gas in cystic fibrosis","volume":"21","author":"Groth","year":"1985","journal-title":"Bull Eur Physiopathol Respir"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2006.04.197"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.10","first-page":"1308","article-title":"Positive expiratory pressure and oscillatory positive expiratory pressure therapies","volume":"52","author":"Myers","year":"2007","journal-title":"Respir Care"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.11","first-page":"211","article-title":"Current devices of respiratory physiotherapy","volume":"12","author":"Hristara-Papadopoulou","year":"2008","journal-title":"Hippokratia"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.12","doi-asserted-by":"publisher","DOI":"10.1378\/chest.114.1.171"},{"key":"2025082802091566000_2014.mar07_1.bcr2013202598.13","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00083605"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-202598","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:09:24Z","timestamp":1756372164000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-202598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,3,7]]},"references-count":13,"alternative-id":["10.1136\/bcr-2013-202598"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-202598","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,3,7]]}}}