Information provided by (Responsible Party): To determine if a therapy regimen including treatment with The MetaNeb System has a positive impact on the rate of pulmonary complications that occur in high risk post-operative patients. (2020). Huang et al. This presents challenges to the assignment of isolation categories because ofconflicting information and uncertainty about possible routes of transmission. Registered Respiratory Therapist with a diverse background in healthcare but a keen interest in trauma intensive care. 0000027826 00000 n https://assets.hillrom.com/is/image/hillrom/MetaNeb_ai0444_0078_shadow?$recentlyViewedProducts$, /en/products/request-more-information/?Product_Inquiry_Type=More%20Information&I_am_most_interested_in=Non-Invasive%20Respiratory%20Therapy&Product_Name=MetaNeb_System, hillrom:care-category/non-invasive-respiratory-therapy, hillrom:sub-category/therapy-oscillation-lung-expansion,hillrom:care-setting/acute-care, https://www.hillrom.it/en/products/the-metaneb-system/#overview-0, https://www.hillrom.it/en/products/the-metaneb-system/#educationdocumentation-1, MetaNeb System Controller close-up, front facing, An older patient in a hospital bed receives therapy from the MetaNeb system, his clinician nearby, A clinician with a gloved hand adjusts a control knob on the MetaNeb System Controller, A clinician with a gloved hand adjusts the MetaNeb Circuit, patient in background, A clinician connects the MetaNeb system to administer therapy to a patient who has been intubated, A clinician with gloved hands connects the MetaNeb system for use with ventilation, A young patient in a hospital bed receives therapy from the MetaNeb system, with help from her clinician, Chronic Obstructive Pulmonary Disease (COPD), Patients who need Post Operative Airway Management, Patients who need Emergency Room Airway Management, Introduces continuous high-frequency oscillation (CHFO) therapy immediately after lungs have been expanded through continuous positive expiratory pressure (CPEP), Integrates aerosol delivery of medications for maximum efficiency. Improve respiratory status and reduce pulmonary complications 1,2; The Vest Airway Clearance System and The MetaNeb System provide therapy using single patient use disposable wraps and circuits. 0000005870 00000 n Medical Design and Outsourcing. endstream endobj startxref Restrictive lung disease with recurrent atelectasis, Mechanically ventilated patients with atelectasis, Patient refractory to traditional bronchial hygiene methods, IPV/Metaneb both utilize High Frequency Oscillatory therapy in conjunction with aerosol therapy to facilitate secretions from smaller airways to larger airways where it can then be expectorated or suctioned. Today, high-frequency oscillation forms the cornerstone of secretion clearance techniques. Background: Metaneb intrapulmonary percussive ventilation device is utilized in pediatric patients as an airway clearance therapy used to clear secretions and promote lung expansion. The MetaNeb System Three therapies. Image from Lei et al. hVn6l1d'R$E[`Z.`$*Dq~w&:$:>E,b|qO4A3 For medication delivery, an Aero Eclipse nebulizer (Trudell Medical International, London, Canada) in continuous mode was used. Paul, MN 55126, PatientsImportance of Respiratory HealthManage My TherapyProductsPatient Stories, Healthcare ProfessionalsBreak the Vicious CycleManage My PatientsProductsVA Government Options, ResourcesVideo LibraryEducation OptionsReimbursement ServicesInsurance CoverageGlossary of Terms, About UsInnovation MilestonesOur VisionCustomer ServiceIn the NewsEvents, Privacy Policy | Terms of Use | HIPAA Notice of Privacy Practices. Wolski is a contributing writer to RT magazine. 10 Minutes Total*: Alternating cycles of CPEP and CHFO combined with aerosol delivery helps maximize therapy effectiveness. These therapies carry similar risk of airborne transmission. Typical self-administered patient treatments consist of two 15- to 30-minute sessions per day. The CoughAssist T70 clears secretions from the lungs by gradually applying positive air pressure (insufflation) to the airway and then rapidly shifting to negative air pressure (exsufflation). 0000005309 00000 n All expected complications are typical in the post-operative cardiac patients and not unique to hyperinflation therapy. 0000004719 00000 n Lei, J., Li, J., Li, X., & Qi, X. In Stage II, a CHANGE IN PRACTICE will be made and patients will receive standard care with the addition of therapy with The MetaNeb System. As with all therapies, the appropriateness of the therapy in individual patients is determined by the treating physician and the health care team. 0000003482 00000 n Its really about coaching the patient on the deep breathing piece, explaining that theyre going to get percussedso they know theres some secretion clearance that will be going on. A wealth of home building and renovating wisdom from years of experience. Droplets are considered particles secreted from a patients respiratory tract that are no smaller than 5m in diameter and travel shorter distances (defined as 3ft) because they cannot stay suspended in air for long periods of time. A variety of strategies have been shown to reduce the risk for development of post-operative atelectasis including lung expansion (LE) therapies. This can be performed in quite a number of ways dependent upon the patient, the lobe that requires the therapy, and any contraindication that can prevent a certain method of therapy. View this study on Beta.ClinicalTrials.gov. trailer <]/Prev 63883>> startxref 0 %%EOF 70 0 obj <>stream Like most modalities, Chest Physiotherapy is not only dependent on the practitioner performing it but the patients willingness to have it done and work with the practitioner. In Stage I of the study, a retrospective review of medical records for post-surgical patients, who received STANDARD THERAPY as defined by current hospital and respiratory care department policies and procedures will be performed. Start the rotator ring in easy mode (1dot) and adjust higher as patient tolerance allows. Health care providers must therefore take the same precautions5. Together, these quality improvements may lead to reduced hospital expenditures and better value-based care for this patient population.. 0000011922 00000 n Such devices provide both LE and airway clearance therapy (ACT) for patients with obstructive and/or restrictive lung diseases and conditions. It is recommended for mobilization of secretions, lung . The device can be used in treating patients with a number of respiratory diseases and conditions, including cystic fibrosis and COPD. (2013). Metaneb System. to 10ft. Huynh, Toan; Cereda, Maurizio; Diette, Gregory; Liesching, Timothy Bookmark, share and interact with the leading medical design engineering magazine today. 472 0 obj <> endobj Spinal surgery involving a posterior approach Surgery for organ transplant Chronic invasive positive pressure ventilation (PPV). Learn more about MetaNeb System. After 20 minutes, or when the cup is empty, the treatment is complete. 0000019337 00000 n 0000002608 00000 n It consists of a pneumatic compressor that delivers OLE therapy using both continuous high-frequency oscillation (CHFO) and continuous positive expiratory pressure (CPEP). Monitor CSF chemistry, cytology, and physiology. The use of oscillatory therapy also helps promote lung expansion, No major difference has shown between choosing over the other as the method of therapy, Both therapies have shown to be helpful in patients with chest wall complications. According to Egans, comparative studies show that IPV is equivalent to other airway clearance strategies in improving short term pulmonary function tests results enhancing sputum expectoration in patients with cystic fibrosis. NOTE: There is no need for CPEP as this therapy can be accomplished with the ventilator. Indications would be worsening oxygenation, increasing FIO2 and/or PEEP, evidence of lung collapse or mucus plugging, and/or retained pulmonary secretions in the absence of an effective cough. MetaNeb System therapy can be utilized to deliver treatment across various inpatient departments, including ED and ICU. The MetaNeb System is indicated for mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis, and also has the ability to provide supplemental oxygen when used with compressed oxygen. Ultimately, the goal is to drive those secretions out to prevent chronic infections. The device was put to the test in a study performed at the Robarts Research Institute, Western University, London, Ontario, and researchers found that the study subjects had improvements in increased mucus clearance, decreased cough frequency and breathlessness, and enhanced exercise tolerance. Study record managers: refer to the Data Element Definitions if submitting registration or results information. Infection Bloody sputum (hemoptysis) The MetaNeb System therapy be used in appropriate patients with an indication for airway clearance and/or lung expansion therapy. Youre really facilitating it in a physical and a physics type treatment delivering that oscillatory breath across the area of the secretion, thinning it down where it can be expectorated by the patient.. Among the specific conditions that can see benefits are patients with neuromuscular diseases, ALS, or any illness that prevents them from adequately expectorating secretions, and who are at an increased risk for developing respiratory infections. hb```B eaq]w,y{9 Y :Y-P%?: - Therapy with the MetaNeb. These results have significant implications in the care of surgical patients who are at high risk for postoperative pulmonary complications, since the integration of MetaNeb System into the respiratory care not only results in reduced complications, but also reduced ventilator time and length of stay in the hospital, notes Huynh. 10. The journey of care isnt over for patients once theyre wheeled out of the OR. One device. We have designed our system to maximize the comfort and assure that it is easy to use, said Kathleen Skarvan, CEO of Electromed. scopic" procedure. The company supports the CoughAssist T70 with numerous training options, including videos, clinician guides, quick start guides, and continuing education programs. And you take time to switch back and forth.. 0 Hospitalized COVID-19 patients are often in need of respiratory support.1. At the same time, the nebulizer is running throughout the entire therapy session. With any therapy, the key is to ensure quality of life and so we have uniquely designed our device with a single hose, which helps us accommodate a softer start and an active inflate and deflate. Provide temporary CSF drainage in patients with infected . While it has been used to treat more than 400 diseases and conditions, it is most commonly used to treat cystic fibrosis, cerebral palsy, quadriplegia conditions, ALS, COPD, and bronchiectasis. The MetaNeb System is indicated for mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis, and also has the ability to provide supplemental oxygen when used with compressed oxygen. All of the secretion clearance devices on the market work according to the same principle of oscillation, so how should RTs choose which is best for them? Nov 1, 2014 | Clinical, COPD, Cystic fibrosis, Monitoring & Treatment, Other Chronic Diseases, Therapy Devices |. Designed by Elegant Themes | Powered by WordPress, Spirometry and Pulse Oximetry Enhance Blood Gas Analysis. Metaneb has a fixed orifice while IPV has a sliding venturi which facilitates the oscillations. (2020, March 2). Put a spring-valve "tee" adapter into the inspiratory limb of the ventilator circuit. As discussed in chest physiotherapy Part 1, CPT is a modality commonly utilized by respiratory therapists in patients in whom the chest x-ray reveals focal lung opacity, evidence of retained secretions, and/or ineffective cough. Study staff will collect data from the medical records, following a protocol determined schedule. Hillrom. Add 20 mL of normal saline or hypertonic saline to the medication cup. CHFO. The device can be used in a number of other scenarios including those patients who have tracheostomies or patients who are ventilator dependent. Read full description Request More Information Overview Education & Documentation Overview MetaNeb Therapy Effective: 07/20/2018 Revised: Continued next page MetaNeb Therapy Purpose The Meta Neb System facilitates mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis and also has the ability to provide supplemental oxygen when used with compressed oxygen. OLE therapy delivered by The MetaNeb System helps expand the lungs and mobilize secretions using Continuous Positive Expiratory Pressure (CPEP), and Continuous High Frequency Oscillation (CHFO). Pathology can be described as a respiratory disease that often progressed into pneumonia with bilateral ground-glass opacities. For further information, contact [emailprotected]. 0000041216 00000 n Get in the know to get the most value out of your solution. The guidelines related to airborne precautions, provided by the CDC should be followed when delivering the therapy.5, Efficacy of Oscillation and Lung Expansion in Reducing Postoperative Pulmonary Complication, Learn how to reduce the length of stay for pneumonia patients. 0000027969 00000 n Select two study versions to compare. @2020 - All Right Reserved. Indications. U.S. Department of Health and Human Services, The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Although PPCs are an incompletely understood multifactorial syndrome, atelectasis is recognized as a critical component. Huynh TT, Liesching TN, Cereda M, et. J Am Coll Surg. Demographic, clinical & outcome data will be collected for eligible patients during the two stages of the study. The MetaNeb System is indicated for mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis, and also has the ability to provide supplemental oxygen when used with compressed oxygen. CT Imaging of the 2019 Novel Coronavirus (2019-nCoV) Pneumonia. A new study suggests the device is having a real, measurable impact on recovery, especially for high-risk patients. The MetaNeb System is a device that delivers continuous highfrequency oscillation (CHFO) and positive expiratory pressure (CPEP) to facilitate pulmonary mucus clearance and provide lung expansion. %PDF-1.5 % https://doi.org/10.1097/BCR.0b013e318257d83e. Intrapulmonary percussive ventilation (IPV) devices have been in use for more than 25 years and are used widely in the acute care, post-surgical, and homecare setting. F/ `X I think it is important to note that a large majority of that therapy relies on that expansion to get that air space opened up.. Although PPCs are an incompletely understood multifactorial syndrome, atelectasis is recognized as a critical component. Retrieved from. Although SARS-CoV is transmitted primarily by contact and/or droplet routes, airborne transmission over a limited distance (e.g., within a room), has been suggested, though not proven.3. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of WTWH Media LLC. Unlike IPV, Metaneb allows the clinician to change rotate between the Oscillatory effect (CHFO) and the lung expansion mode (CPEP). The MetaNeb System combines lung expansion, secretion clearance, and aerosol delivery into a single integrated therapy sessionwithout having to switch between different devices. Get in the know to get the most value out of your solution. The possible complications listed below: Over distention of air sucks (alveoli). The Medical Device Business Journal. The CoughAssist T70 is designed for use with any patient unable to cough or clear secretions effectively due to reduced peak cough expiratory flow (less than 5-6 liters per second), resulting from high spinal cord injuries, neuromuscular deficits, or severe fatigue associated with intrinsic lung diseases. Researchers from three medical centers in the U.S. examined the efficacy of integrating the MetaNeb System in the respiratory care for patients undergoing major chest or abdominal surgery, explains Huynh. 0000027091 00000 n Between Metaneb and IPV there have been no studies to show significant differences. Earlier this year, the Aerobika received the Gold award at the Medical Design Excellence Awards (MDEA). endstream endobj 473 0 obj <. 0000001552 00000 n As a result, the CoughAssist T70 is a more gentle, comfortable way to remove secretions, keeping airways clear longer than trached suction and with fewer complications, Diacopoulos said. After 2 minutes of CPEP, switch to CHFO mode at a lower frequency setting. The therapy can be administered by the patient or the RT. Talk with your doctor and family members or friends about deciding to join a study. Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. 0000034614 00000 n The study will be conducted in two stages. Ann Intern Med. 0000003919 00000 n Sometimes pressure trauma in your lung may cause pneumothorax. 165 0 obj <> endobj The MetaNeb System, offered by Hill-Rom, addresses post-surgical respiratory problems that can impair a patients recovery. PURPOSE: The management of pulmonary complications of patients with chronic debilitation conditions such as cerebral palsy . Medical Design and Outsourcing. To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Atelectasis and secretion retention in combination are major risk factors for those prone to alveolar collapse such as those with muscular weakness, patients on ventilators, and the pediatric population. The MetaNeb System, by mobilizing mucous secretions and lung expansion, may have contributed to these clinical improvement, Huynh says. However, it does work on the same principle of using oscillations to thin and dislodge mucus in the patients lungs. MedTech 100 is a financial index calculated using the BIG100 companies covered in Retrieved from, https://www.hillrom.com/en/products/the-metaneb-system/, Ortiz-Pujols, S., Boschini, L. A., Klatt-Cromwell, C., Short, K. A., Hwang, J., Cairns, B. Patients who may benefit from The MetaNeb System include those with pulmonary atelectasis or secretions associated with the following conditions: *Therapy times may differ depending on patient needs and ordered therapies. Risk Assessment for and Strategies To Reduce Perioperative Pulmonary Complications for Patients Undergoing Noncardiothoracic Surgery: A Guideline from the American College of Physicians. All Rights Reserved. Patient Requires Prolonged Mechanical Ventilation, Patient requires prolonged respiratory support for > 24 hours post-surgery, Diagnosis of Pneumonia Within Seven (7) Days, Readmission to ICU (or transfer to an elevated level of care) for pulmonary complications within seven (7) days of discharge. It delivers a rapidly repeating pulse of air alternately squeezing and releasing the upper bodyeach squeeze simulates a mini cough, which acts to loosen the mucus from the walls of the airways. IPV promotes mobilization of secretions, provides nebulized therapy, and provides intrathoracic vibration and percussion, thus improving ventilation. While oscillating technology is essential to secretion clearance, RTs and other clinicians have a number of options for the way it can be done, as the following representative devices from Hill-Rom, Philips Respironics, Electromed, and Monaghan Medical Corp illustrate. Using the MetaNeb System During the COVID-19 Pandemic 1. ACT uses physical or mechanical means to manipulate air flow,tomobilizesecretionscephalad,andtofacilitateevac-uation by coughing.11 Breathing maneuvers, gravity as-sisted drainage, manual techniques, and mechanical de-vices can be used in an effort to facilitate secretion mobilization. Read our, ClinicalTrials.gov Identifier: NCT02627742, Interventional The results demonstrated that incorporating MetaNeb therapy led to a significant reduction in postoperative pulmonary complications, less time on mechanical ventilation, and reduced hospital length of stay.. The therapy is well tolerated by stable patients and appears to offer an alternative in patients with chest wall compliance. The MetaNeb System has been shown to treat pneumonia, trauma, post-op, chronic respiratory conditions, and other conditions to improve respiratory status and reduce pulmonary complications. And then youre able to loosen it and bring it up through the airway. 0 With the MetaNeb, you can seamlessly switch between recruiting an expansion of the lung, which is ultimately what patients need, to take a deep breath, through CPEP, and transition over to CHFO and pull those secretions from that expanded air space and clear their lungs, Mellor said. The MetaNeb System is an LE expansion modality that incorporates all the physiological effects of IPV while providing additional therapeutic advantages intended primarily to more effectively treat or prevent pulmonary atelectasis. Pathology can be described as a respiratory disease that often progressed into pneumonia with bilateral ground-glass opacities.