a) The Spiration (Spiration, Inc. , Redmond, WA, USA) device a) The Spiration (Spiration, Inc., Redmond, WA, USA) device. b) The device is arranged so that the convex surface is positioned distally, with the aim of allowing expiratory but not inspiratory flow. a) The Spiration (Spiration, Inc., Redmond, WA, USA) device. b) The device is arranged so that the convex surface is positioned distally, with the aim of allowing expiratory but not inspiratory flow. M. I. Polkey, and N. S. Hopkinson Eur Respir Rev 2006;15:99-103 ©2006 by European Respiratory Society