Acapella: Difference between revisions

No edit summary
No edit summary
 
(13 intermediate revisions by 3 users not shown)
Line 1: Line 1:
<div class="editorbox">
'''Original Editor '''- [[User:Rochelle Dsouza| Rochelle Dsouza]]
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}  &nbsp; 
</div>
== Background ==
== Background ==
An ineffective cough or an impairment of normal mechanisms of mucociliary clearance limits oxygen transport from the lungs to body tissues. An array of techniques for assisting the mobilization of airway secretions is available for patients and caregivers to augment a patient’s mucus mobilization and expectoration. The caregiver must consider the pathophysiology and the clinical manifestations of the disease, the physiological basis of the method, availability of the technique to the patient, and the patient’s acceptance of the technique when prescribing an optimal method of airway clearance.  
An ineffective cough or an impairment of normal mechanisms of mucociliary clearance limits oxygen transport from the lungs to body tissues. A variety of techniques are available for assisting the mobilization of airway secretions to augment a patient’s mucus mobilization and expectoration. The caregiver must take into consideration the pathophysiology and the clinical manifestations of the disease, availability of the technique to the patient, and the patient’s acceptance of the technique when prescribing an optimal method of airway clearance.<ref name=":0">Faarc, Kacmarek Robert PhD Rrt, et al. Workbook for Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020</ref>
[[File:Acapella.jpg|thumb]]


== Introduction ==
== Introduction ==
The Acapella is a Oscillatory PEP device that provides oscillation to the airways which helps loosen secretions and move them centrally. The Acapella delivers high-frequency oscillation and PEP by employing a counterweighted lever and magnet. Exhaled gas passes through a cone, which is intermittently occluded by a plug attached to the lever, producing air flow oscillations. A knob located at the distal end of the device adjusts the proximity of the magnet and counterweighted plug, thereby adjusting the frequency, amplitude, and mean pressure
The Acapella is an Oscillatory [[Positive Expiratory Pressure (PEP) Devices|PEP device]] that provides oscillation to the airways which helps loosen secretions and move them centrally. The Acapella delivers high-frequency oscillation and PEP by employing a counterweighted lever and magnet. Exhaled gas passes through a cone, which is intermittently occluded by a plug attached to the lever, producing air flow oscillations. A knob located at the distal end of the device adjusts the proximity of the magnet and counterweighted plug, thereby adjusting the frequency, amplitude, and mean pressure. <ref name=":0" /><ref name=":1">Volsko TA, DiFiore JM, Chatburn RL. Performance comparison of two oscillatory positive pressure devices: Acapella versus Flutter. Respiratory Care 2003; 48(2):124-30. </ref>


{{#ev:youtube|L5gEwEIkRjo}}
Below is a short video about this device:
{{#ev:youtube|pq-ZMLMFgUI|300}}<ref>Health Products For You.Smiths Medical Acapella Vibratory PEP Therapy System. Available from:https://www.youtube.com/watch?v=pq-ZMLMFgUI [last accessed 30/4/2024]</ref>


== Parts of the Acapella ==
== Parts of the Acapella ==
Line 16: Line 24:
== How to use ==
== How to use ==


For someone using the Acapella for the first time, make sure the '''frequency adjustment dial is set counterclockwise to the lowest frequency-resistance setting.'''
When using the Acapella for the first time, make sure the '''frequency adjustment dial is set counterclockwise to the lowest frequency-resistance setting.'''
 
{{#ev:youtube|uOscl37oHzg|300}}<ref>CMC Vellore. Use of Acapella for Airway Clearance for Cystic Fibrosis Patients. Available from: https://www.youtube.com/watch?v=uOscl37oHzg [last accessed 31/3/2022]</ref>


* Sit in a chair by keeping your back straight. Keep your elbows resting comfortably on the table. Now, tilt your head slightly upward.
* Sit on a chair in a upright posture. Keeping your back straight and elbows resting comfortably on a table. Now gently, tilt your head slightly upwards thus keeping the upper airways open.
* This will help to keep the upper airway open wide. As a result, the air you exhale will be able to flow out smoothly.  
* Take a deeper breath than normal inhalation. Making sure that your lips are wrapped around the mouthpiece, then with a forceful exhalation blow into the device.  
* Take a breath that is deeper than a normal inhalation. Make sure that your lips make a tight seal around the mouthpiece, then blow into the device with a forceful exhalation.
* Ideally, you should blow out about twice as fast as normal.  
* Typically, you should blow out about twice as fast as normal, but not as hard as you can.
* Continue this process for approximately 10 breaths.
* Repeat this process for approximately 10 breaths.
* After the final attempt, make sure to expel to remove the secretions from the airways. Additionally, you can even perform 2 to 3 “huff” to enhance secretion removal as needed.
* After the final attempt, be sure to cough, in order to remove the secretions from the airways. You can even perform 2 to 3 “huff” coughs in order to increase secretion removal as needed.  
* Note: You must be able to exhale for at least three to four seconds while using the device. Failing to maintain your exhalation for this advised length of time, requires you to turn the adjustment dial to increase the resistance.
* Note: You must be able to exhale for at least three to four seconds while using the device. If you fail to maintain your exhalation for this advised length of time, then you need to turn the adjustment dial to increase the resistance.
* This adjustment helps the patient exhale at a lower flow-rate by raising the total resistance of the vibrating orifice.<ref>Patterson JE, Hewitt O, Kent L, Bradbury I, Elborn JS, Bradley JM. Acapella versus 'usual airway clearance' during acute exacerbation in bronchiectasis: a randomized crossover trial. Chron Respir Dis. 2007;4(2):67-4</ref>
* This adjustment will help the patient exhale at a lower flow-rate by raising the total resistance of the vibrating orifice.


== Types of Acapella ==
== Types of Acapella ==
Line 31: Line 40:


# Green device for patients who can sustain at least 3 seconds of expiratory flow '''> 15 L/min'''
# Green device for patients who can sustain at least 3 seconds of expiratory flow '''> 15 L/min'''
# Blue device for patients with expiratory flow  '''15 L/min'''.
# Blue device for patients with expiratory flow  < '''15 L/min'''.


==Indications==
==Indications==
Line 50: Line 59:
# Untreated pneumothorax
# Untreated pneumothorax
# Hemoptysis
# Hemoptysis
# Intracranial pressure > 20 mmHg
# Acute dyspnea
# Severe nausea


== Advantages ==
== Advantages ==
The Acapella may offer advantages to some patients by virtue of its ability to generate OPEP at any angle (eg, with the patient supine) and at very low expiratory flows (eg, in children with severe obstructive lung disease). REFERENCES
The Acapella is advantageous to some patients due to its ability to generate OPEP at any angle (eg, with the patient supine) and at very low expiratory flows (eg, in children with severe obstructive lung disease)<ref name=":1" />
 
== References ==
<references />
[[Category:Respiratory Disease - Interventions]]
[[Category:Cardiopulmonary]]

Latest revision as of 08:33, 30 April 2024

Original Editor - Rochelle Dsouza

Top Contributors - Rochelle Dsouza, Nikhil Benhur Abburi and Mohit Chand  

Background[edit | edit source]

An ineffective cough or an impairment of normal mechanisms of mucociliary clearance limits oxygen transport from the lungs to body tissues. A variety of techniques are available for assisting the mobilization of airway secretions to augment a patient’s mucus mobilization and expectoration. The caregiver must take into consideration the pathophysiology and the clinical manifestations of the disease, availability of the technique to the patient, and the patient’s acceptance of the technique when prescribing an optimal method of airway clearance.[1]

Acapella.jpg

Introduction[edit | edit source]

The Acapella is an Oscillatory PEP device that provides oscillation to the airways which helps loosen secretions and move them centrally. The Acapella delivers high-frequency oscillation and PEP by employing a counterweighted lever and magnet. Exhaled gas passes through a cone, which is intermittently occluded by a plug attached to the lever, producing air flow oscillations. A knob located at the distal end of the device adjusts the proximity of the magnet and counterweighted plug, thereby adjusting the frequency, amplitude, and mean pressure. [1][2]

Below is a short video about this device:

[3]

Parts of the Acapella[edit | edit source]

  1. Removable mouthpiece
  2. Body of the device
  3. Expiratory resistance dial, which allows the patient to adjust the difficulty of breathing into the device
  4. One-way inspiratory valve

How to use[edit | edit source]

When using the Acapella for the first time, make sure the frequency adjustment dial is set counterclockwise to the lowest frequency-resistance setting.

[4]

  • Sit on a chair in a upright posture. Keeping your back straight and elbows resting comfortably on a table. Now gently, tilt your head slightly upwards thus keeping the upper airways open.
  • Take a deeper breath than normal inhalation. Making sure that your lips are wrapped around the mouthpiece, then with a forceful exhalation blow into the device.
  • Ideally, you should blow out about twice as fast as normal.
  • Continue this process for approximately 10 breaths.
  • After the final attempt, make sure to expel to remove the secretions from the airways. Additionally, you can even perform 2 to 3 “huff” to enhance secretion removal as needed.
  • Note: You must be able to exhale for at least three to four seconds while using the device. Failing to maintain your exhalation for this advised length of time, requires you to turn the adjustment dial to increase the resistance.
  • This adjustment helps the patient exhale at a lower flow-rate by raising the total resistance of the vibrating orifice.[5]

Types of Acapella[edit | edit source]

The Acapella is available in 2 models:

  1. Green device for patients who can sustain at least 3 seconds of expiratory flow > 15 L/min
  2. Blue device for patients with expiratory flow < 15 L/min.

Indications[edit | edit source]

  1. Mucus-producing respiratory conditions, including:
  2. Atelectasis
  3. Bronchitis
  4. Bronchiectasis
  5. Cystic Fibrosis
  6. Chronic Obstructive Pulmonary Disease (COPD)
  7. Asthma
  8. Respiratory Muscle Weakness
  9. Mechanical Ventilation
  10. Neonatal Respiratory Distress Syndrome

Contraindications[edit | edit source]

  1. Untreated pneumothorax
  2. Hemoptysis

Advantages[edit | edit source]

The Acapella is advantageous to some patients due to its ability to generate OPEP at any angle (eg, with the patient supine) and at very low expiratory flows (eg, in children with severe obstructive lung disease)[2]

References[edit | edit source]

  1. ↑ 1.0 1.1 Faarc, Kacmarek Robert PhD Rrt, et al. Workbook for Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020
  2. ↑ 2.0 2.1 Volsko TA, DiFiore JM, Chatburn RL. Performance comparison of two oscillatory positive pressure devices: Acapella versus Flutter. Respiratory Care 2003; 48(2):124-30.
  3. ↑ Health Products For You.Smiths Medical Acapella Vibratory PEP Therapy System. Available from:https://www.youtube.com/watch?v=pq-ZMLMFgUI [last accessed 30/4/2024]
  4. ↑ CMC Vellore. Use of Acapella for Airway Clearance for Cystic Fibrosis Patients. Available from: https://www.youtube.com/watch?v=uOscl37oHzg [last accessed 31/3/2022]
  5. ↑ Patterson JE, Hewitt O, Kent L, Bradbury I, Elborn JS, Bradley JM. Acapella versus 'usual airway clearance' during acute exacerbation in bronchiectasis: a randomized crossover trial. Chron Respir Dis. 2007;4(2):67-4
Retrieved from "https://www.physio-pedia.com/index.php?title=Acapella&oldid=353775"