Smiths Medical Acapella Vibratory PEP Therapy System

Brand/Manufacturer: SMITHS MEDICAL
Item # Desc Pkg Price
21-1530 DH with Mouthpiece, High Flow, Green $1.35
21-1015 DM with Mouthpiece, Low Flow, Blue $2.62
Smiths Medical Acapella Vibratory PEP Therapy System combines the benefits of both PEP therapy and airway vibrations to mobilize pulmonary secretions. It can be used in virtually any position allowing patients to move freely and sit, stand or recline. Acapella inhaler facilitates opening of airways in patients having lung diseases with secretory problems such as COPD, asthma and Cystic Fibrosis. It gives 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.

Acapella Vibratory PEP Therapy System Features

  • 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
  • Frequency and flow resistance of Acapella breathing device can be adjusted by turning an adjustment dial
  • Can be used in any position - 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

Benefits of PEP THerapy

  • Allows inhalation and exhalation without removing from mouth 
  • Prolongs expiratory airflow to increase 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 - 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

Pressure Therapy Curve

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

Acapella PEP Therapy System Includes:

  1. Removable mouthpiece
  2. Acapella Vibratory PEP Device with 22 mm male fittings including:
    A. Expiratory resistance/frequency adjustment dial
    B. One-way inspiratory valve
    C. Patient end which adapts to a mouthpiece, or mask
    D. Mouthpiece (detachable)

How does the Acapella Device work?

Acapella Breathing Device by Smiths Medical directs exhaled air through an opening which is periodically closed by a pivoting cone. As air passes through the opening, the cone alternately closes and opens the air flow 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 changes.

Acapella Respiratory Device indications:

  • Acapella is intended for use as a single patient use device that provides Positive Expiratory Pressure (PEP) Therapy for patients who have Cystic Fibrosis, COPD, asthma, and lung diseases with 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 of Acapella PEP Device

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

What to buy with Acapella Vibratory PEP Therapy System


How to use Acapella Vibratory PEP Device?

Initial Settings -
  1. If this is the first use of Acapella DM & DH Vibratory PEP Therapy System, ensure that frequency adjustment dial is turned counterclockwise to lowest frequency-resistance setting.
  2. Instruct the patient to relax while performing diaphragmatic breathing and inspiring a volume of air larger than normal tidal volume (but not to 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 length of time, adjust the dial clockwise. 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: If the desired resistance and I:E ratio cannot be achieved, consider use of an Acapella device designed for alternate flow ranges.
  7. Once the proper 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 feel 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 correct range as identified by your clinician.
  2. Sit with elbows resting comfortably on table.
  3. Place mouthpiece lightly in mouth.
  4. Be sure to maintain a tight seal on the mouthpiece during exhalation.
  5. Your clinician may recommend the use of a nose clip if necessary.
  6. If using a mask, apply mask tightly but comfortably over 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 recommended by clinician. Remove mouthpiece and perform 2-3 huff coughs to raise secretions as needed. Your clinician may direct you on proper cough technique.
  11. Repeat steps 2 to 7 as prescribed.

How to clean Acapella PEP System

As needed, detach mouthpiece then 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

Acapella Vibratory PEP Therapy System FAQs

1. What is the difference between Blue and Green Acapella?

Acapella GreenAcapella Blue
  • =15 L/min expiratory flow
  • Ideal for most patients
  • Can tee-in a small volume nebulizer
  • Easy to clean, rinse & flush with warm soapy water
  • Best for short-term, hospital use
  • < 15 L/min expiratory flow
  • Geriatric and pediatric patients
  • Can tee-in a small volume nebulizer
  • Easy to clean, rinse & flush with warm soapy water
  • Best for short-term, hospital use

2. How often should I use my Acapella?

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 health care provider how many times a day you can use Acapella. Use Acapella 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 an expiratory resistance. It is used for the clearance of excess lung secretions, reduction of gas trapping and improvement of lung ventilation.

4. How long does an Acapella Breathing Device last?

Acapella choice is a single patient-use device 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, and the high-flow unit means that it works at more than 15 LPM for 3 seconds.

Acapella PEP Therapy Reviews


ItemName - now     12/01/2021

  Your question will show here once it will get approved.

UserName - now     12/01/2021

  Your Answer will show here once it will get approved.



Valorie     09/01/2019

How do you take it apart..  I tried doing it like the u-tube directions and it will not come apart.


robbhicks    10/10/2020

The Acapella DH is intended for hospital use and does not come apart. The pressure dial is set by the hospital doctor, and as intended, it cannot be turned and adjusted by the patient.

The Acapella Choice, also green but with slightly clearer plastic, is for hospital and home use. It easily comes apart as online videos demonstrate and the pressure dial can be turned to let you adjust it.

Both units are green, most online Acapella resources don't distinguish between these two different models, and there are very few online resources specifically about the Acapella DH.



T Costlow     12/23/2018

Can I disassemble my device for a thorough cleaning?


Customer Care    12/25/2018

Yes, you can disassemble device for cleaning. Please  follow the cleaning instructions as below: 

Cleaning with Liquid Dish Detergent: As needed, detach mouthpiece (mask) then soak the device and mouthpiece in warm, soapy water as required to remove visible contaminants. Use a liquid dish detergent (Dawn or equivalent), mixing two (2) tablespoons of detergent per one (1) gallon water. Rinse thoroughly with sterile water, and allow parts to air dry. Drain the device by placing it in a normal resting position.



jay     11/28/2016

just wondering high flow an low flow i am buying this for a friend that has copd so whats the difference between these two


Customer Care    12/01/2016

The Blue one (i.e. Low Flow) is for Kids or adults with mild issues of mucus and getting a productive cough. The Green(i.e. High Flow) is a bit stronger vibration for the harder to get up congestion, sometimes feels impossible


{{x.ShortDescription}} ...

What is HPFY’s return policy?

Customer satisfaction is our top priority. We stand behind our products. If the merchandise you received is defective or not what you expected it to be, and you wish to return the item, please submit a return request in the My Account section of our website, contact our Customer Service department at (866) 316-0162 / (203) 616-2850 or email us.

  1. Merchandise must be returned within 30 days of the receipt of your order. Returns are not accepted after 30 days.
  2. Items (including parts and accessories) must be returned in new, unused, and resalable condition in its original packaging.
  3. Before returning any product, the buyer must obtain a Return Authorization Number (RA#) from a customer service representative. With your RA# you will receive a prepaid return shipping label.
  4. Orders returned without obtaining an RA# will be entitled to receive only "In-Store Credit" that can be used towards future purchases.
  5. Return orders are subject to a 20% restocking fees.
  6. All custom orders and hygienic items are non-returnable. Refer to the “Non-Returnable Items” section for further details.
  7. Returns will be reviewed and inspected before issuing credit. Please allow 3 to 4 weeks for processing. The credit will be applied to your original method of payment.
  8. If the return is the result of a defective product or shipping error, we will refund the entire purchase amount and return shipping costs.

Which products are Non-Returnable?

Due to the hygienic nature of some items, they are non-returnable. The items listed below are non-returnable:

  1. All hygienic items.
  2. Opened personal care items.
  3. Anything opened, used, or tried on.
  4. All customized items.
  5. Besides these, items that have the “non-returnable” phrase on the website.

We reserve the right to make adjustments due to errors, changing market conditions, product discontinuation or typographical errors in advertisements. Images on the site may not always reflect the actual product. Footrests or leg-rests are not included with wheelchairs unless specified.

How do I receive a return authorization number?

You can submit a return request by logging into your account. You will receive the Return Authorization Number (RA#) details in the email within 2-3 business days.

  • Login to your account
  • Go to “order history”
  • Click on “return order”
  • Fill out the return form and Submit it

If you do not have an email address, we will make other accommodations for RA# Details. Write the RA# on your label affixed to your package prior to shipment.

How long does it take to receive a refund?

Please allow 3 to 4 weeks to process the returns. Once the item is received, and inspected, your refund will be processed and automatically applied to your credit card or original method of payment.

Is there any Restocking Fees?

  1. 20% restocking fees will be applied.
  2. Outbound shipping cost is non-refundable.
  3. For orders that qualified for free shipping, $8.99 will be deducted from the refund if the product is returned.

More PEP Therapy System

{{'Buy ' + x.Name}}
${{ x.OurPrice | currency: "" : 2}}
Please enter your and your friend's email address below.
Fields marked with * are compulsory

Submit Cancel
The selected product information along with Reward Dollar coupon code has been successfully emailed to you and your friend.

Thank you for using