4 - Volara / MetaNeb

role of Volara/MetaNeb

lung recruitment and secretion mobilization

indications for Volara/MetaNeb

• post-operative (atelectasis)

• neuromuscular

• COPD, CF, bronchiectasis

• impaired inspiratory effort

contraindications and precautions for Volara/MetaNeb

• untreated pneumonia

• hemodynamic instability

• active hemoptysis

• severe air trapping

device overview and mechanism of action

• Volara Works

  • CPEP

  • CHFO

  • nebulizer

• MetaNeb

  • lung expansion, secretion, clearance, nebulizer

  • cycles between PEP & CHFO

  • adjustable settings (pressure, frequency, time)

[continuous] positive expiratory pressure (CPEP/PEP)

• continuous, clinician-set airway pressure above atmospheric pressure

• provides this pressure for inspiration and expiration (continuous flow with inspiration, resistance with expiration)

• prevents/treats atelectasis

• aids in mobilization of retained secretions

• reduces incidence of air trapping

continuous high-frequency oscillation (CHFO)

pneumatic form of chest physiotherapy

• creates/maintains mean airway pressure that maintains airway caliber, prevents premature closure, and expands collapsed lung regions

• creates pressure gradient to small airways where secretions are trapped; accelerated flow on expiration

• delivers hyperinflation therapy

possible adverse reactions of Volara/MetaNeb

• hyperventilation

• gastric distension

• decreased cardiac output

• increased ICP

• increased air trapping

• hyperoxygenation

• pneumothorax

• pulmonary air leak

• pulmonary hemorrhage