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Researchers develop innovative breathing aid to improve breathing in people with COPD.

The development of a new breathing device by pulmonologists at the University of Cincinnati holds promise for improving their lives.

The new device not only improves COPD symptoms and quality of life, but it also helps people who are stressed or anxious, as well as those who practice mindfulness, meditation, or yoga.

The research was published in the journal Respiratory Care.

The device, called PEP Buddy, was created by Muhammad Ahsan Zafar, MD, and Ralph Panos, MD. Zafar is an associate professor in the Department of Pulmonary Critical Care and Sleep Medicine at the UC College of Medicine while Panos is a professor emeritus in pulmonary and critical care at the UC College of Medicine and is the director of the national tele-ICU program for the U.S. Veterans Affairs.

Muhammad Ahsan Zafar, MD, of the Division of Pulmonary, Critical Care and Sleep Medicine/Photo/Andrew Higley/UC Marketing + Brand

“Dr. Panos and I both see patients with COPD, and it’s a huge population,” says Zafar. “Their life really changes when they have COPD. They were active individuals but now they’re debilitated and limited, so we wanted to come up with something easy that helps improve their life.”

Due to tighter air tubes, it takes longer for COPD patients to expel inhaled air from their lungs with each breath. As a result, when they breathe quickly, such as during physical activities, air is retained in the lungs. This air stacking, also known as “dynamic hyperinflation,” is the primary cause of shortness of breath and lower oxygen levels. People become less active and more isolated as their breathing becomes more difficult during physical activity.

Panos and Zafar created a handheld device the size of a whistle. When Zafar looked at the market for positive-expiratory pressure (PEP) breathing devices, he noticed that they were handheld, large, and bulky, so they set out to create something that is simple, lightweight, and easy to use. The device is intended to be worn around the neck with a lanyard on a daily basis and inserted into the mouth when necessary, either during or after exertion.

In the study, they examined people with COPD who were short of breath and gave them two tasks.

Researchers develop innovative breathing aid to improve breathing in people with COPD
Muhammad Ahsan Zafar, MD, of the Division of Pulmonary, Critical Care and Sleep Medicine/Photo/Andrew Higley/UC Marketing + Brand

“We conducted a six-minute walk test with and without the device,” says Zafar. “They were given the device to take home and use in their daily routines. In two weeks, there was a follow-up to see how PEP Buddy use impacted their shortness of breath and quality-of-life scores.”

The study found 72% of the participants had a significant impact in reducing their shortness of breath and improving their quality of life. Among those who would drop their oxygen levels during walking, 36% of them did not drop oxygen levels when using PEP Buddy. This is the first mechanical device to show such an impact on oxygen levels in people with COPD.

As a physician I feel gratified that we are providing something new that can actually improve people’s lives.

Muhammad Ahsan Zafar, MD

Maja Flannery, a PEP Buddy user with chronic lung disease and airflow obstruction, says the device has changed her day-to-day living.

“I am so happy that I was lucky enough to be part of the study and able to use this great little device to breathe better,” Flannery says. “I use it when I get up in the morning. It helps with the air requirement when changing position from laying down to standing and exercises my lungs to get them more prepared for the day. I find it helpful in getting the trapped air out as I am active, so I can play longer points during tennis, and also recover between points more quickly. My friends at tennis laugh that it is my ‘magic whistle.’”

UC’s Zafar says the next step in this research is to conduct a long-term study to see the impact on the use of rescue inhalers, emergency department visits, and long-term symptoms and functional capacity in people with COPD. PEP Buddy may also be a promising addition to pulmonary rehabilitation programs for faster improvement and sustaining better outcomes. They are also exploring other uses of PEP Buddy in health care.

“As a physician I feel gratified that we are providing something new that can actually improve people’s lives,” says Zafar. “That’s where my passion is. These people are really debilitated with not many tools in their hand to improve their symptoms right now. PEP Buddy will be one such tool.”

PEP Buddy is one of the many startups that have come out of the UC Venture Lab pre-accelerator program and received seed funding.

UC’s Venture Lab, operated by the Office of Innovation, provides a launch pad for entrepreneurs to turn their ideas into a startup reality. The UC Venture lab is located in the 1819 Innovation Hub in the Cincinnati Innovation District, providing a connection point to talent, support, and funding to help launch new companies