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inspiration
in respiratory
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UNIKO-TPEP® E
PATENTED
The natural solution for patients with chronic respiratory disease
0051
UNIKO-TPEP® E for effective secretion removal,
targeted respiratory exercise and efficient medication distribution
UNIKO-TPEP® E is a unique, gentle, non-invasive respiratory therapy device for airway clearance, exercise
and nebulised medication delivery, developed for adult and paediatric patients who are able to breathe
spontaneously and who fall into the following disease or patient types:
COPD
Pre- and post-surgical. Cystic fibrosis. Bronchiectasis
How it works:
UNIKO-TPEP® E operates at a very low expiratory pressure of 1cmH20 and does not require pressurised air or oxygen.
There is no inspiratory pressure, therefore it is safe to use for patients who may be at risk of barotrauma. It is easy,
comfortable and safe for the patient to use in complete autonomy, so that after brief training given by nursing or
physiotherapy staff, the patient is able to effect the treatment without need of assistance, at home or in the hospital
setting.
The patient sits in a chair or in bed and breathes into a mouthpiece. A gentle but deep breathing pattern is required to
trigger the sensor and a low pressure of 1cmH20 is provided at the beginning of the expiratory phase. This low pressure
is halted just before the end of the expiratory phase (TPEP® temporary positive expiratory pressure) but the patient
continues to breathe out and as a result is gently extending their lungs and recruiting pulmonary space which was
previously less ventilated.
Patients’ airways having been cleared of secretions during the therapy session with UNIKO-TPEP® E are more readily
available to absorb medication. Moreover, using the FASTERJET® aerosol chamber for drug administration, the
medication is delivered in particle size MMAD 2,44μn, which means that it can reach the peripheral airways faster and
potentially penetrate deeper. The mouthpiece design incorporates a one-way valve so that there is little or no escape of
medication into the atmosphere, ensuring that the patient receives the optimum supply.
Depending upon the patient’s age and the state and type of respiratory illness, the level of improvement can be seen after
just a few days of therapy using UNIKO-TPEP® E two to three times a day for 30 minutes.
Inspiratory phase:
The patient inspires at atmospheric pressure without
any additional pressure support.
Insp/Exp pressure
Exp pressure + TPEP®
Expiratory phase:
A sensor activates the resistance pump which
delivers a flow resistance (=1cmH2O) against the
patient’s expiratory flow.
pump
sensor
UNIKO-TPEP® E at home:
Patients can use UNIKO-TPEP® E at home whilst easily
adapting it into their daily routines. The breathing
technique is soon learnt as the combination of the
sensitivity of the sensor and the easy–to-view feedback
on the display results in an almost intuitive response from
the patient as to the best breathing pattern for their own
individual needs. Within 5 to 10 days of daily use, with
drug therapy as appropriate, there is a noticeable
improvement in the patient’s health which further helps
to promote their well-being and compliance with their
treatment regime.
As lung health improves by the prescribed use of
UNIKO-TPEP® E at home there may be the potential to
reduce the risk of admission to hospital for respiratory
management.
UNIKO-TPEP® E in the hospital setting:
Surgery:
Patients affected by respiratory disease are at an
elevated risk during anaesthesia compared to patients
with healthy lungs. Preparing the patient for surgery is
of particular concern for all surgical staff in trying to
reduce hospitalisation time and avoiding the
consequences of post-operative ventilation. As
evidenced in a scientific study(1) UNIKO was used with a
COPD patient with a BMI >30 who was to undergo
major abdominal surgery, UNIKO was beneficial in all
three areas of patient care: pre-operative preparation,
reducing the length of stay (LOS) in intensive care and
reducing the period of post-operative hospitalisation.
In the ward:
Patients benefit significantly as they can carry out their
therapy regime in the comfort of their own hospital
bed.
Budget and cost considerations:
UNIKO-TPEP® E helps to reduces recovery time which
saves time and precious resources.
UNIKO-TPEP® E and the benefits for your
patient
All 3 key benefits are available to the patient
in one unit: secretion removal, targeted airway
exercise and efficient medication distribution.
Enhanced detachment and removal of secretions
TPEP® is the result of several years of research
by combining various rehabilitation techniques
and studying the effect of different pressures
on the alveoli. TPEP® is a non-invasive, gentle
but effective therapy which works with the low
pressures naturally found in the alveoli and
thus assists the airways’ own mechanisms to
detach and remove secretions. TPEP® is
provided with a light flutter in the air flow
which further helps to promote removal of
secretions.
Targeted airway exercise
‘TPEP® causes a rapid improvement of pulmonary
function, characterised by a reduction in the degree
of pulmonary hyperinflation and a concurrent
physiological redistribution of pulmonary volumes
(reduction in residual volume and increase in
relaxed vital capacity) and of ventilation distribution’.(2)
Efficient medication distribution
The improved distribution of nebulised
medication and the potential to reach the
peripheral airways makes pharmacological
treatment more effective compared to normal
aerosol use.
Features:
Large and clear display is easy to understand
and visually logical : both patient and carer
have immediate feedback on the patient’s
breathing effort making the breathing
technique easier to understand and follow
further helping with patient compliance.
A minute counter appears above the named
therapy as the session starts: provides
immediate information to both patient and
clinician and removes any doubt as to the
therapy time spent.
Push button controls provide fast access to
parameters measured: helps the clinician to
monitor patient’s progress and compliance.
Push button control to change the patient’s
therapy effort level: helps the patient to use
the therapy according to their individual
needs and allows the physiotherapist to adjust
the effort level as the patient’s condition
improves.
Lightweight and compact with an easy grip
handle and supplied in a transport bag: makes
UNIKO-TPEP® E easy to carry for the patient at
home and for the carer in the hospital or clinic.
Quiet operation: the patient can comfortably
use UNIKO-TPEP® E in the home or hospital
setting.
Comfortable: the very low pressure on
expiration only and the gentle breathing
technique means that the therapy session can
be comfortable and stress free.
UNIKO-TPEP® E ‘at a glance’
•UNIKO-TPEP® E can be used in complete
autonomy by any spontaneously breathing
patient.
•Does not require pressurised air or oxygen.
•Due to the very low pressure of 1cmH₂0 on
expiration only it can be used in complete
safety for patients at risk of barotrauma.
•The efficient removal of secretions is a direct
result of the gentle exercise of the airways and
recruitment of alveoli.
•The improvement in the distribution of medication
is due to the particle size generated by the aerosol
and by medication being administered after
treatment with TPEP® therapy.
(1)
Lung ventilation scintigraphy in the assessment of obstructive lung diseases
Authors: P. Fazzi1 R. Albertelli1 M. Grana2 P.L. Paggiaro1
1
Cardio-Thoracic and Vascular Dept and2 General Surgery and Transplantations, University of Pisa, Italy
Breathe | March 2009 | Volume 5 | No 3
(2)
Positive expiratory pressure techniques in respiratory patients: old evidence and new insights
Author: E. Clini
University of Modena(RE) – Italy
Breathe | December 2009 | Volume 6 | No 2
UNIKO-TPEP® E
CLINICAL EVIDENCE¤
Efficacy of temporary positive expiratory pressure to assist patients with chronic hypersecretion. a multicentre
randomised trial
Elena Venturelli1, Ernesto Crisafulli1, Bruno Balbi2, Luca Bianchi3, Guido Vagheggini4, Piergiorgio Schiavoni5,
Michele Vitacca3, Michele Zaurino5, Nicolino Ambrosino4, Adrian Kendrick6 and Enrico M.Clini1 on behalf of the
UNIKO study group
1
Ospedale Villa Pineta and University of Modena, Pavullo n/F; Fondazione Maugeri IRCCS, Centers of 2Veruno and
3
Lumezzane; 4Auxilium Vitae Rehabilitation Center, Volterra; 5Ospedale San Giuseppe, Milano; 6Bristol Royal
Infirmary, Bristol. Italy and UK
ERS 2010 Barcelona
Intermittent Positive Pressure with TPEP®
SpO2 % in TPEP® group
pz 1
pz 2
pz 3
pz 4
pz 5
pz 6
0
1
2
3
4
5
6
days
SpO2 % in C.G.
pz 7
pz 8
pz 9
pz 10
pz 11
pz 12
0
1
2
3
4
5
6
days
(a)
Scintigraphic images of pulmonary
ventilation taken in posterior/anterior
projection after inhalation of albumin
markers with Tc99m diluted in saline
solution of 0,9%.
COPD patient with a prevalence of
emphysema, before and 5 days after
treatment with UNIKO-TPEP®.
(b)
Improvement in SpO2 following abdominal
surgery in COPD patients treated with
UNIKO-TPEP® compared to a control group
given standard therapy
Effectiveness of the Temporary Positive Expiratory Pressure during aerosol therapy in the management of
patients with tracheobronchial stent
Marchese R* , Paglino G*, Gebbia V**
*Department of Interventional Pulmonology,**Department of Medical Oncology, Oncologic Center La
Maddalena, Palermo, Italy
ERS 2010 Barcelona
The effects of T-PEP on ventilation lung scan in patient with bronchiectasis: protocol for randomized controlled
trial
Authors: P.Fazzi1,A.D'Abrosca2,R. Cristofani3,S. Derlin1, G. De Cusatis1, S. Antonelli1, FL Dente1, PL Paggiaro1
1
Cardio-Thoracic and Vascular Department, University of Pisa, 2 Experimental Pathology, Medical Biotechnology,
Infection Disease and Epidemiology department, University of Pisa, Pisa Italy
ERS 2010 Barcelona
Positive expiratory pressure techniques in respiratory patients: old evidence and new insights
E. Clini
University of Modena(RE) – Italy
Breathe | December 2009 | Volume 6 | No 2
A short term evaluation of temporary positive pressure (T-PEP) in airway clearance vs pep mask in cystic fibrosis
patients
Brivio A., Caverni E., Costantini D.
Paediatric clinic de Marchi, cystic fibrosis centre, Milano
XV CF Congress Italy 2009
Preliminary study of the efficacy of the respiratory rehabilitation system “T-PEP UNIKO”® versus pep mask in
improving functional parameters of patients with severe hypersecretions in COPD and bronchiectasis
Authors: A. Frijia1, M. Zingoni1, M. Solinas1, G. Borelli2, R. Albertelli1, M. Petrilli1
1
Fondazione Don Gnocchi Marina di Massa (MS), 2Cardio-Thoracic Dept University of Pisa Italy
Italian journal of physiotherapy and respiratory rehabilitation – Anno VIII No 2 May-August 2009
Efficacy of temporary positive expiratory pressure (TPEP) device in chronic hypersecretion. The UNIKO project.
Authors:Ernesto Crisafulli1, Bruno Balbi2, Luca Bianchi3, Guido Vagheggini4, Enrico Guffanti5, Michele Vitacca3,
Nicolino Ambrosino4, Enrico M.Clini1
1
Villapineta (MO), 2FSM Veruno (NO), 3FSM Lumezzane (BS), 4Auxilium Vitae Volterra (PI), 5INRCA Casatenovo (LC)
ERCA congress Stresa 2009
Efficacy of the respiratory rehabilitation system “T-PEP UNIKO”® versus pep mask in improving functional
parameters of patients with severe copd and bronchiectasis
Authors: 1A. Frijia, 1M. Zingoni, 1M. Solinas, 2G. Borelli, 1R. Albertelli, 1M. Petrilli
1
Fondazione Don Gnocchi Marina di Massa (MS), 2Cardio-Thoracic Dept University of Pisa Italy
ERCA congress Stresa 2009
Respiratory physiotherapy in abdominal major surgery. Leading study of a rehabilitative protocol with UNIKO
TPEP®
Zeroli Francesca, D’Amanzio Erminia, Boni Luigi
Università dell’ Insubria Varese Italy
ERCA congress Stresa 2009
Chest physical therapy in chronic bronchitis. the effect of temporary positive expiratory pressure (TPEP) and
eltgol. what is the best? the key is patient satisfaction
G. Schiavoni, A. Pediconi, P. D’ Ambrosio,L. Fallarino, M.Iannì, F.Yaine, C. Cigolini, M. Zaurino
Hospital San Giuseppe Milan, Italy
ERCA congress Stresa 2009
Efficacy of pulmonary rehabilitation programme(PRP) with TPEP® (TEMPORARY POSITIVE EXPIRATORY
PRESSURE) about removal bronchial secretions, pulmonary function test,dyspnoea and exercise tolerance in
COPD patients
Authors: Ferri L, Di Toro S., Dall’Armi V., Cardaci V.
IRCCS San Raffaele la Pisana Rome, Italy
ERCA congress Stresa 2009
Lung ventilation scintigraphy in the assessment of obstructive lung diseases
Authors: P. Fazzi1 R. Albertelli1 M. Grana2 P.L. Paggiaro1
1
Cardio-Thoracic and Vascular Dept and 2General Surgery and Transplantations, University of Pisa, Italy
Breathe | March 2009 | Volume 5 | No 3
(c)
Dynamic ventilation for 12 min (1 frame per 30”) during UNIKO-TPEP® treatment.
Respiratory physiotherapy in major abdominal surgery. Pilot study of a rehabilitation protocol with the UNIKO
TPEP system
Thesis of student: Francesca Zeroli
UNIVERSITA’ DEGLI STUDI DELL’INSUBRIA - Corso di Laurea in Fisioterapia Varese 2008
Efficacy of T-PEP® (Temporary Positive Expiratory Pressure, model UNIKO) in clearing bronchial obstructions:
design proposal of a study
Master in phyiotherapy and respiratory rehabilitation : Antonella Cortelezzi
UNIVERSITA’ DEGLI STUDI DI MILANO – 2008
Aerosol therapy using IPPB with TPEP: a future prospect to complete the treatment of bronchiolitis ?
Authors:R. Startari, M. Pandolfi, R.M. Porzia, L. Notari, R. Ghilardi, L. Bernardo
Azienda ospedaliera Fatebenefratelli ed Oftalmico - Paediatric department Milano
MINERVA PEDIATRICA Vol. 60 - N. 5 - Pag. 1244 (October 2008)
Abdominal surgery in COPD: utility of IPPB with temporary expiratory pressure (T-PEP) on distribution of
ventilation and gas-exchange.
Authors: P.Fazzi1, R.Albertelli1, M.S.Derlin1, G.Girolami1, M.Grana2, F.Mosca2, C.Giuntini1
1
Cardiothoracic Department, University of Pisa, Pisa, Italy; 2General Surgery and Transplantations, University of
Pisa, Pisa, Italy
ERS annual congress Berlin 2008
(d)
The overall stent complications rate was reduced with less infections and mucus
obstructions requiring bronchoscopic clearence in patient treatment with UNIKO-TPEP®.
(a)
Abdominal surgery in COPD: utility of IPPB with temporary expiratory pressure (T-PEP) on distribution of ventilation and gas-exchange - ERS 2008
(b)
®
Respiratory physiotherapy in abdominal major surgery. Leading study of a rehabilitative protocol with UNIKO TPEP - ERCA Stresa 2009
c)
Positive expiratory pressure techniques in respiratory patients: old evidence and new insights - Breathe | December 2009 | Volume 6 | No 2
Effectiveness of the TPEP® during aerosol therapy in the management of patients with tracheobronchial stent - ERS 2010 Barcelona
Ippb with temporary expiratory pressure (t-pep) in surgical patients with COPD
Authors: P. Fazzi 1, G. Girolami2, R. Albertelli1, M. Grana2, F. Mosca2, C. Giuntini1
1
Cardiothoracic Department, University of Pisa Italy. 2General surgery and transplantation, University of Pisa Italy
ERS annual congress Stockholm 2007
The use of a temporary positive pressure (T-PEP) in surgical patients with COPD
Authors: p. fazzi(1), g. girolami(2), r. albertelli(1), m. grana(2), f. mosca(2), c. giuntini(1)
affiliations: (1)dipartimento cardiotoracico, universita' degli studi di pisa pisa italy, (2)chirurgia
generale e trapianti, universita' degli studi di pisa pisa italy
7° National Congress on Pulmonology SIMeR – Florence 2006
(b)
TECHNICAL SPECIFICATION
Model: UNIKO-TPEP® E
Power supply: 220-230V AC – 50 Hz
Absorption: 300VA
Class, electrical protection: ll Applied Part Type B
Fuse: T2A – 250V
Dimensions and weight: 27 x 23 x 13 cm - 3,350 Kg
Aerosol compressor maximum pressure : 300kPa
TPEP® compressor maximum pressure: 200kPa
Aerosol air flow: 15 l/min
TPEP® air flow: 12 l/min
Operating airflow from aerosol compressor: 7 l/min (at 90 kPa)
Noise level: < 60 dBA (1m distance, frontal position)
Norm : CEI EN 60601-1 - CEI EN 60601-1-2 – EN 13544
Conforms to: Medical Device Directive: 93/42/CEE (2007/47/EC)
Warranty: 24 months
The above information is correct at time of printing and maybe changed due to our policy of
continuous improvement.
©
MPR Srl
Preliminary evaluation in the use of a temporary positive pressure (T-PEP) in respiratory therapy in patients with
Cystic Fibrosis.
Authors: E. Rizza, M. Bernardi*, R. Bini*, E.G. Barlocco*
Centro Regionale di Medicina Nucleare Università Pisa
*Servizio per la Fibrosi Cistica - U.O. Pediatria e Neonatologia Ospedale Misericordia Grosseto
XII Italian Congress on Cystic Fibrosis Florence 2006
The new system TPEP®(Temporary Positive Expiratory Pressure)
Author: Roberto Albertelli - Dipartimento Cardiotoracico, Universita' degli studi di Pisa Italy
pg. 22-23 PNEUMORAMA 41 / XI / 4-2005
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