The Science Journal of the American Association for Respiratory Care

2000 OPEN FORUM Abstracts

ACAPELLA VS FLUTTER: PERFORMANCE COMPARISON

Teresa A. Volsko RRT, Julie DeFiore BSEE, Robert L. Chatburn RRT, FAARC Case Westem Reserve University, Cleveland, Ohio

Ocillatory positive expiratory pressure (PEP) using the Flutter device (Scandipharm Inc.) has been shown effective in secretion removal (J Pediatr 1994; 124:689). A new device, the Acapella, (DHD Healthcare Corp.), has become available. In the Flutter, a steel ball vibrates in a cone causing airflow vibrations. The Acapella uses a counterweighted plug and magnet in place of a steel ball. It comes in two sizes, one for patient's with expiratory flows of >15 L/min (green in color) and one for flows <15 L/min (blue in color). We hypothesize that the Acapella and Flutter would produce similar mean pressure (PEP), oscillatory pressure amplitude and frequency over a range of flows.

Methods:
Oscillatory amplitude, PEP and frequency were measured with data acquisition software designed for blood pressure measurement (Biosystems XA, Buxco Electronics Inc.) The sample rate was 200 Hz. Data were collected as mean values every second over a 5 second sample period as flow through the device was varied from 5 to 30 L/min, in 5 L/min increments. The devices were adjusted to give low and high range oscillations (Flutter angle at 0 ° and 30 °, Acapella by dial setting).

Results:
Data in figure are mean ± standard error over all flows (F = Flutter, B = blue Acapella, G = green Acapella). The Acapella gave less consistent waveforms than Flutter at low range but was more consistent than Flutter at high range. Both devices gave similar amplitudes and frequencies, but the Acapella produced a wider range of PEP. When data were plotted against flow, both devices tended to increase amplitude and PEP but not frequency with increasing flow.

Conclusions:
The Acapella and Flutter are flow operated oscillatory PEP devices with similar performance characteristics. The Acapella is not gravity (ie, positionally) dependent and is therefore easier to adjust. (See Original for Figure)

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