Excessive dynamic airway collapse (EDAC) contributes to breathlessness and reduced quality of life in individuals with emphysema. We tested a novel, portable, oral positive expiratory pressure (o-PEP) device in a patient with emphysema and EDAC. MRI revealed expiratory tracheal narrowing to 80 mm² that increased to 170 mm² with the o-PEP device. After 2-weeks use of the o-PEP device for 33% to 66% of activities, breathlessness, quality of life, and exertional dyspnea improved compared with minimal clinically important differences (MCID): University of California-San Diego Shortness of Breath questionnaire score declined 69 to 42 (MCID, ≥5), St. George’s Respiratory Questionnaire score decreased 71 to 27 (MCID, ≥4), and before and after the 6-minute walk test Borg score difference improved from Δ3 to Δ2 (MCID, ≥1). During the 6-minute walk test on room air without the use of the o-PEP device, oxyhemoglobin saturation declined 91% to 83%; whereas, with the o-PEP device, the nadir was 90%. Use of the o-PEP device reduced expiratory central airway collapse and improved dyspnea, quality of life, and exertional desaturation in a patient with EDAC and emphysema.

过度动态气道塌陷 (EDAC) 会导致肺气肿患者出现呼吸困难和生活质量下降。我们在一名患有肺气肿和 EDAC 的患者身上测试了一种新型的便携式口服呼气正压 (o-PEP) 装置。MRI 显示呼气气管狭窄至 80 mm ²，然后增加到 170 mm ²使用 o-PEP 设备。使用 o-PEP 设备进行 33% 至 66% 的活动 2 周后，与最小临床重要差异 (MCID) 相比，呼吸困难、生活质量和劳力性呼吸困难得到改善：加州大学圣地亚哥分校呼吸急促问卷评分从 69 分下降到 42 分（MCID，≥5），圣乔治呼吸问卷评分从 71 分下降到 27 分（MCID，≥4），并且在 6 分钟步行测试前后 Borg 评分差异从 Δ3 提高到 Δ2（MCID， ≥1)。在不使用 o-PEP 装置的室内空气中进行 6 分钟步行测试期间，氧合血红蛋白饱和度下降了 91% 至 83%；而使用 o-PEP 设备时，最低点为 90%。o-PEP 装置的使用减少了 EDAC 和肺气肿患者的呼气中央气道塌陷并改善了呼吸困难、生活质量和劳力性去饱和。