Vibralung Tracheostomy Interface

Simultaneous Aerosol Therapy

The Vibralung Acoustical Percussor is best coupled to the airway through a direct mouthpiece interface.  However, alternative interfaces that couple to an artificial airway such as an endotracheal tube (ETT), or more commonly a tracheostomy tube (“trach”) are available for those patients in whom a mouthpiece cannot be effectively utilized.  In addition, a mask interface in two sizes (adult and pediatric) is also available for certain patients who are able to use it effectively.

The family of Vibralung interface devices has been designed with maximum versatility and adaptability in mind to readily connect to the airway of patients in whom the conventional mouthpiece approach is not able to be used. The objective of such therapy is to loosen secretions and promote mucokinesis, with or without adequate cough, in patients with neuromuscular/paralytic disease that predisposes to respiratory compromise and respiratory failure. This would logically include patients with various neuromuscular/paralytic disorders that have resulted in upper airway compromise, weakness of inspiratory and expiratory musculature, inability to take deep breaths or inability to cough and expectorate effectively. Generally, this could include patients with Guillain-Barré syndrome, myasthenia gravis, bulbar poliomyelitis, tetanus (Clostridium tetani), botulism (Clostridum botulinum), organophosphate (insecticide) poisoning, and Duchenne muscular dystrophy among others.  In addition, patients with high spinal cord injuries that has resulted in plegia with respiratory muscle involvement are also candidates for Vibralung therapy.

To the extent that these patients can use the Vibralung via the mouthpiece interface, they should.  But in the event that they have an artificial airway such as a trach tube, often placed for long-term care and treatment, therapy will be best applied by directly coupling the Vibralung to the trach tube.  , 

The fundamental trach interface adapter is depicted in the drawing below:

Remove the Standard Y-adapter, replace with the Aerosol Y-adapter, and transfer the mouthpiece to the Aerosol Y-adapter. Insert the Circulaire II Hybrid aerosol delivery system on to the tail of the Aerosol Y-adapter. The entire configuration should appear as shown in the “bird’s eye view” drawing above.

The Circulaire II Hybrid, when coupled with the Vibralung Acoustical Percussor via the Aerosol Y-adapter, provides a pathway for inhalation and exhalation with minimal mechanical dead space, while the Aerosol Y-adapter provides a straight and unimpeded waveguide for the sound waves to travel through. In this manner, the acoustical energy remains coupled to the patient’s airway during inhalation and exhalation.

Further, PEP can also be administered by way of the Circulaire, which has a Variable Expiratory Resistor on the exhalation port. Finally, because many of the patients who may benefit from ACT and simultaneous aerosol therapy via the Vibralung Acoustical Percussor also have pulmonary infections, an exhalation filter is included in the exhalation pathway of the Circulaire to prevent fugitive medications and patient droplets from being emitted into the room and possibly inhaled by caregivers, other patients or family members.

Instructions for Use, as well as instructions for cleaning and disinfecting the Circulaire II Hybrid aerosol drug delivery system, can be found in the downloadable online manuals below.

 

Vibralung Online Manuals

Information in the online manuals is always current and may supercede printed documents.

Click on a thumbnail image to download the specific manual(s) you desire in PDF format.

Online Manual System Instructions Patient Kit Instructions

Circulaire II Hybrid Instructions for Use

Click the Circulaire II Hybrid thumbnail image below to download the Instructions for Use in PDF format. 

For further information on the Circulaire II family of aerosol delivery systems, please visit the Circulaire II High-Efficiency Aerosol Drug Delivery Systems page.

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