12/8/2023 0 Comments Acapella flutter valve cleaning![]() A long-term (1-year) study comparing the Flutter to a PEP mask demonstrated better clinical outcomes in PEP mask users compared to Flutter users 7 but a recent review of evidence in PEP therapy concluded that this therapy was unsupported by literature, 8 and one study indicated that PEP masks do not improve inhaled drug delivery. As a result, PEP masks have been used for years in cystic fibrosis care. In theory, this will result in greater patency of airways that tend to collapse (such as in bronchiectasis) and greater ability to clear airways with coughing. TheraPEP ® (Smiths Medical Inc, Carlsbad, Calif) Exhaling against a resistor will result in higher pressures within the airway. These devices can be purchased for under $60. This device originally came in a low-flow and a high-flow model and now is available as the “acapella ® Choice” model that can be broken down for cleaning it can be used in line with a nebulizer. ![]() 6 The authors concluded that the magnetic design had an advantage in ease of use for some patients despite what appeared to be otherwise relatively small differences in performance. 5 In a head-to-head comparison of the performance characteristics of acapella and the Flutter, the acapella had a slight advantage in a more stable waveform and a wider range of positive expiratory pressure. By using a valve with a magnet, the acapella does not require gravity to work and will therefore work at any angle. ![]() It works on the same principle-an oscillating valve interrupting expiratory flow-but uses a counterweighted plug and magnet to achieve the valve closure. This was overcome in the design of the “acapella” handheld mucus clearance device. 4 This device can be purchased for under $50.Īcapella ® (Smiths Medical Inc, Carlsbad, Calif) A characteristic of the Flutter device is that it must be held at a precise angle in order to maximize the oscillation of the air column. 3 A follow-up study showed that the Flutter device is at least as effective as other forms of secretion mobilization for patients with cystic fibrosis. The value of using a handheld device rather than traditional CPT has been demonstrated. Konstan et al 2 showed that the volume of sputum produced was greater than that produced by manual CPT. 1 The first device to challenge the supremacy of this therapy became popular following the publication of a report in the Journal of Pediatrics in 1994 by Konstan et al 2 it demonstrated efficacy in secretion mobilization for a handheld device called the “Flutter,” which was a modification of a PEP (positive expiratory pressure) device in which a steel ball oscillated up and down in a cone, vibrating the column of air between the mouth and the lower airways. Handheld Secretion Mobilization Devices Flutter ® (Axcan Scandipharm Inc, Birmingham, Ala) In diseases with impaired mucociliary clearance (cystic fibrosis, bronchiectasis, primary ciliary dys-kinesia, acquired ciliary dyskinesia), the mainstay of therapy for decades has been manual chest physiotherapy (CPT), also known as percussion and drainage. This review will cover some of the devices available to aid in airway clearance. Patients with neuromuscular weakness have been able to benefit from a new use of an old technology to assist with coughing. Recognition of the critical role of secretion mobilization in cystic fibrosis (CF) and other related diseases of impaired airway clearance has led to the interesting challenge of having a large number of devices available to aid in secretion mobilization. * Mahimeister MJ et al.Various devices have proven effective in airway clearance we take a look at some of them You can adjust the acapella® frequency and flow resistance simply by turning an adjustment dial.Īcapella® DM & DH Vibratory PEP Therapy System features: It improves clearance of secretions, is easier to tolerate than Chest Physical Therapy (CPT), takes less than half the time of conventional CPT sessions* and facilitates opening of airways in patients with lung diseases with secretory problems such as COPD, asthma and Cystic Fibrosis. Color-coded units (green for high-flow, blue for low) help customize treatment for each patient based on their clinical needs. PEP devices have been found to give independence to patients with chronic respiratory diseases as the therapy can be done when convenient for the patient and without the need for an assistant.Īcapella® combines the benefits of both PEP therapy and airway vibrations to mobilize pulmonary secretions and can be used in virtually any position allowing patients to move freely and sit, stand or recline. Positive Expiratory Pressure (PEP) therapy is used to mobilize secretions.
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