Smiths Medical Acapella Vibratory PEP Therapy System

Features of Acapella Breathing Device

• Reduce air trapping, common with asthma and COPD
• Aid in the mobilization of retained secretions, as are found in cystic fibrosis and chronic bronchitis
• Prevent or reverse atelectasis
• Optimize the delivery of bronchodilators
• Color-coded units help customize treatment for each patient based on their clinical needs
• The frequency and flow resistance of the acapella device can be adjusted by turning an adjustment dial
• It can be used in any position - the patient is free to sit, stand, or recline
• Easier to tolerate than Chest Physical Therapy (CPT)
• Takes less than half the time of conventional CPT sessions
• Acapella Blue-DM <15 lpm for 3 seconds
• Acapella Green-DH >15 lpm for 3 seconds
• 22mm OD ambient end
• 22mm OD patient end
• Patented rocker mechanism
• Single patient use device

Product Benefits

• Allows inhalation and exhalation without removing from mouth 
• Prolongs expiratory airflow to increase the removal of secretions 
• Allows use with mask or mouthpiece attachment 
• Allows use with inline nebulizer when fitted with tee adapter
• Accommodates virtually any patient’s lung capacity
• Can be used in any position - the patient is free to sit, stand, or recline

With vibrations added

• Reduces mucus viscoelasticity
• Loosens, shears & disengages secretions from airways
• Mobilizes secretions from distal to central airways

 

How does the Acapella Device work?

Acapella Device by Smiths Medical directs exhaled air through an opening that is periodically closed by a pivoting cone. As air passes through the opening, the cone alternately closes and opens the airflow path. The result is a vibrating pressure waveform. For most users, frequencies between 0-30 Hz are obtained while maintaining positive pressure throughout the exhalation process. This is referred to as vibratory PEP therapy.
Through adjusting the dial, the frequency of the vibrating pressure waves and the resistance of the opening change.

User Guides

• Smiths Medical Acapella Vibratory Pep Device - Brochure
• Smiths Medical Acapella Pep Device - User Guide

Indications

• It is intended as a single patient-use device that provides Positive Expiratory Pressure (PEP) Therapy for patients with Cystic Fibrosis, COPD, asthma, lung diseases, secretory problems, and patients with atelectasis.
• It may also be used simultaneously with nebulized aerosol drug delivery.
• Green: Acapella DH is recommended for patients able to maintain an expiratory flow of 15 liters per minute or greater for 3 seconds.
• Blue: Acapella DM is recommended for patients capable of less than 15 liters per minute for 3 seconds.

Contraindications

Although no absolute contraindications to the use of PEP therapy have been reported, the following should be carefully evaluated before a decision is made to initiate therapy:

• Inability to tolerate increased work of breathing
• Known or suspected tympanic membrane rupture or other middle ear pathology
• Hemodynamic instability
• Intracranial pressure (ICP) > 20 mm Hg
• Acute sinusitis
• Recent facial, oral or skull surgery or trauma
• Epistaxis
• Esophageal surgery
• Active hemoptysis
• Untreated pneumothorax
• Nausea

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How do you use Acapella vibratory PEP therapy?

Initial Settings

1. If this is the first use, ensure the frequency adjustment dial is turned counterclockwise to the lowest frequency-resistance setting.
2. Instruct the patient to relax while performing diaphragmatic breathing, inspiring air volume larger than normal tidal volume (but not total lung capacity).
3. Direct the patient to exhale to functional residual capacity (FRC) actively but not forcefully through the device.
4. The patient should be able to exhale for 3-4 seconds while the device vibrates. If the patient cannot maintain an exhalation for this time, adjust the dial clockwise. The clockwise adjustment increases the resistance of the vibrating orifice, which will allow the patient to exhale at a lower flow rate.
5. Selection of the proper resistance range produces the desired inspiratory to expiratory (I: E) ratio of 1:3 to 1:4.
6. Note: Consider alternate flow ranges if the desired resistance and I: E ratio cannot be achieved.
7. Once the acceptable range has been identified, the patient may be instructed to exhale harder or softer, or dial adjustments may be made to optimize the response the user feels from the vibratory pressure.
8. Several uses may be needed to ensure that the individual patient needs are being met.

Procedure for the User

1. Ensure the adjustment dial is set to the correct range as identified by your clinician.
2. Sit with elbows resting comfortably on the table.
3. Place the mouthpiece lightly in the mouth.
4. Be sure to maintain a tight seal on the mouthpiece during exhalation.
5. Your clinician may recommend using a nose clip if necessary.
6. If using a mask, apply the mask tightly but comfortably over the nose and mouth.
7. Breathe from the diaphragm, as directed by your clinician, taking in a larger-than-normal breath but not filling your lungs to capacity.
8. Hold your breath for 2-3 seconds.
9. Exhale actively, but not forcefully, through the device. Exhalation should last approximately 3 to 4 times longer than inhalation.
10. Perform 10-20 PEP breaths as the clinician recommends. Remove the mouthpiece and perform 2-3 huff coughs to raise secretions. Your clinician may direct you to the proper cough technique.
11. Repeat steps 2 to 7 as prescribed.

Cleaning Instructions

As needed, detach the mouthpiece, soak the parts in warm soapy water, rinse, and dry. Drain the device by placing the unit with the mouthpiece end downward or by resting the unit on its side.

Estimated Device Lifetime

Assuming the manufacturer-recommended cleaning protocol is followed, the acapella device should have a useful life of six (6) months under normal and customary usage. The six (6) month usage duration is measured from the date of initial use.

Acapella Vibratory PEP Therapy System User Guide
 

FAQs

1. What is the difference between blue and green acapella devices?

2. How often should I use my device?

Use it 2 to 4 times a day for 15 minutes (or as prescribed by your health care provider). You'll be told by your healthcare provider how many times a day you can use it. Use for 15 minutes after you inhale the drug if you are using a short-acting inhaled bronchodilator.

3. What is PEP therapy?

Positive expiratory pressure (PEP) therapy involves breathing with a slightly active expiration against expiratory resistance. It is used to clear excess lung secretions, reduce gas trapping, and improve lung ventilation.

4. How long does it last?

Acapella devices are single patient-use devices and reusable. Replaced it every six months.

5. What is the difference between low and high-flow units?

Low-flow unit means the unit works at less than 15 LPM (liters per minute) for 3 seconds, while a high-flow unit works at more than 15 LPM for 3 seconds.

6. How to clean it?

Take the mouthpiece off the Acapella body. The mouthpiece and body need to be washed. Clean the mouthpiece and body of the acapella daily with liquid dish detergent – rinse with water.