Three therapies. One closed circuit.
BiWaze® Clear delivers lung expansion, high-frequency oscillation, and nebulization in one ~10-minute session — through a closed, dual-lumen breathing circuit designed to keep exhaled aerosol contained and filtered, not released into the room.
Retained secretions drive post-operative pulmonary complications
Shallow breathing and weak cough lead to retained secretions — a primary contributor to PPCs, which remain one of the most common and costly complications after surgery.
¹ Miskovic A, Lumb AB. Br J Anaesth 2017;118(3):317–334; Dimick JB et al. J Am Coll Surg 2004;199(4):531–537.
Oscillating lung expansion (OLE) therapy was developed to address this. See how BiWaze Clear works →
Integrated therapy, intelligent design
Closed-Circuit Design to Minimize Aerosol Exposure
BiWaze® Clear features a closed, dual-lumen breathing circuit that separates inhaled and exhaled airflow. Exhaled air and aerosol pass through a filtered pathway, helping minimize aerosol release into the surrounding environment. Laboratory testing demonstrated reduced fugitive aerosol emissions compared with other systems evaluated.¹
Independent Dual-Blower Technology
Two electronically controlled blowers independently regulate inspiratory and expiratory airflow. Integrated sensors and software algorithms adjust blower performance to support precise, consistent delivery of programmed therapy.
In-Line Ventilator Compatibility
FDA-cleared for in-line use with mechanical ventilators, BiWaze Clear delivers oscillating lung expansion (OLE) therapy without disconnecting the ventilator circuit. High-frequency oscillations help mobilize secretions for suctioning, with optional nebulization during therapy.
Four interface options, one system:
Mouthpiece
For cooperative patients who can seal around a mouthpiece
Face mask
Adult and pediatric options
Trach adapter
Connects to endotracheal or tracheostomy tubes
In-line vent
In-line with the ventilator circuit — hospital care only
¹ DiBlasi R, Kontoudios N, KenKnight H. Assessment of Oscillatory Pressure and Flow Waveforms With the BiWaze® Clear System: A Study in Vitro. Seattle Children’s Hospital & Research Institute; ABM Respiratory Care; 2025.
3 therapies. 1 session. ~10 minutes.
BiWaze Clear combines lung expansion, oscillation, and integrated nebulization to help open the airways, mobilize secretions, and deliver nebulized saline — in one approximately 10-minute session.
Lung expansion (PEP)
Positive expiratory pressure holds the airways open, creating a path for secretions to move — helping re-expand collapsed areas of the lung.
Oscillation (OSC)
High-frequency oscillations help loosen and mobilize secretions from the airway walls, with an expiratory flow bias that moves mucus toward the central airways.
Nebulization (Neb)
The integrated Aerogen® Solo vibrating-mesh nebulizer delivers aerosol during PEP, OSC, or as a stand-alone treatment — without opening the circuit — to help thin and loosen secretions.*
Therapy goals: reduce airway obstructions, re-expand collapsed areas of the lung, and enhance gas exchange. * Saline only; currently pending FDA clearance for medications.
Contained. Complete. Simple.
Contained
- Closed dual-lumen breathing circuit — inspiratory and expiratory flow paths are separated
- Exhaled airflow is routed through a coaxial bacterial/viral filter
- Dual-blower technology independently manages airflow and pressure
- Reduced fugitive aerosol demonstrated in laboratory testing¹
Complete
- Lung expansion, high-frequency oscillation, and integrated nebulization in one system
- Three therapies in one ~10-minute session
- Integrated Aerogen® Solo nebulizer with built-in controller
- Up to 10 customizable therapy profiles
Simple
- Patients sit comfortably and breathe through the therapy
- Simplified touchscreen interface with manual and auto modes
- Easy-to-assemble breathing circuit
- 9 lb with an included internal battery — moves between rooms on a mobile cart
¹ DiBlasi R, Kontoudios N, KenKnight H. Assessment of Oscillatory Pressure and Flow Waveforms With the BiWaze® Clear System: A Study in Vitro. Seattle Children’s Hospital & Research Institute; ABM Respiratory Care; 2025.
BiWaze Clear research and two decades of OLE literature
Independent bench studies
In laboratory testing conducted by an independent lab, BiWaze Clear demonstrated a strong expiratory flow bias (PIF/PEF < 0.9) across adult and pediatric lung models — 2–3× more expiratory flow bias vs. other OLE systems tested — with consistent pressure delivery, up to 4.5× greater aerosol deposition to the lungs, and less fugitive aerosol than other OLE systems tested.¹˒²
Read the oscillation & flow white paper → Read the aerosol comparison study →OLE therapy and post-operative outcomes
A multi-center study of OLE therapy in high-risk post-surgical patients reported a statistically significant reduction in PPCs (22.9% to 15.8%), with reduced hospital length of stay (8.4 to 6.8 days) and reduced ventilator time for intubated patients (23.7 to 8.5 hours).³
Study conducted with a predecessor OLE device (the MetaNeb System); not a BiWaze Clear clinical trial. An evidence-generation program for BiWaze Clear is underway.
¹ DiBlasi R, Kontoudios N, KenKnight H. Assessment of Oscillatory Pressure and Flow Waveforms With the BiWaze Clear System: An In Vitro Study. Seattle Children's Hospital & Research Institute; ABM Respiratory Care; 2025. ² Kontoudios N, KenKnight H, DiBlasi R. In vitro comparison of aerosol delivery in high-frequency assisted airway clearance devices with integrated nebulizers. Respir Care. 2024;69(10):1221-1230. ³ Huynh TT, et al. J Am Coll Surg 2019;229(5):458-466.e1.
A protocol-friendly therapy
Titrate in manual mode to find comfortable, effective settings — then program auto mode for consistent delivery. Reassess each shift.
Manual mode titration
Begin with PEP 5–10 cm H₂O and OSC 10–15 cm H₂O, medium frequency (4 Hz), adjusting to patient tolerance.
Auto mode profiles
Save up to 10 pre-programmed therapies; each phase — PEP, OSC, NEB — is programmed independently with its own pressure, duration, and nebulizer settings.
OSC + Neb in-line
For mechanically ventilated patients, use OSC with Neb in manual mode, matched to ventilator settings per protocol. Suction as needed.
Refer to the product User Manual and your facility protocol for complete guidance. Sample protocol available from ABM Respiratory Care.
Used across the hospital and beyond
Critical & emergency care
- ICU
- Trauma / Burn
- Transplant
- Emergency
Inpatient units
- Medical / Surgical
- Pediatrics
- Bariatrics
Post-acute & long-term care
- Rehab
- Subacute
- Long-term care
From hospital to home — one connected ecosystem
BiWaze Clear is part of the BiWaze platform. When patients go home on therapy, Arc Connect helps them and their home-care providers track sessions, set goals and reminders, and stay connected between visits.
The reference layer.
| Therapies | PEP (1–30 cm H₂O) · OSC (5–70 cm H₂O; low 3 Hz, med 4 Hz, high 5 Hz) · NEB-only option — each phase programmed independently (5 sec to 30 min) |
| Modes & presets | Manual and Auto modes · up to 10 therapy profiles with customizable names · lock feature to hide modes or restrict edits |
| Nebulizer | Integrated Aerogen® Solo vibrating-mesh nebulizer with built-in controller (aerosol FDA-cleared for saline only) |
| Circuit | Closed, coaxial dual-lumen breathing circuit with bacterial/viral filter · single-patient use · 30 days or 90 typical therapies, whichever comes first |
| Interfaces | Mouthpiece · face mask · trach adapter · in-line with ventilator (hospital care only) |
| Device | 9 lbs including internal lithium-ion battery (up to 10 nominal 10-minute therapies per charge) · simplified touchscreen · mobile cart available for hospital and long-term care |
| Regulatory | FDA 510(k) K260604 · View the FDA clearance letter (PDF) → |
Product images
Downloads
Clinical evidence
Clinical tools
Bring BiWaze® Clear to your facility
Whether you’re ready to learn more, see BiWaze Clear in action, evaluate the system, or move forward with implementation, our team is here to help. Connect with us for a demonstration, clinical in-service, product evaluation, value analysis support, and staff training.
BiWaze Clear FAQ.
How long is a therapy session?
A typical session is about 10 minutes, combining lung expansion (PEP), high-frequency oscillation (OSC), and nebulization as programmed by the care team.
Can BiWaze Clear be used with ventilated patients?
Yes — BiWaze Clear is FDA-cleared for use in-line with a ventilator in hospital care environments. For ventilated patients, use OSC with Neb in manual mode.
What makes the circuit different?
The closed, dual-lumen breathing circuit separates the inhale and exhale paths and routes exhaled airflow through a coaxial bacterial/viral filter — designed to keep exhaled aerosol contained rather than escaping into the room.
Which medications can be nebulized?
The integrated Aerogen® Solo nebulizer is FDA-cleared with the system for saline only.
Manual or auto mode?
Both. Manual mode supports real-time titration; auto mode runs up to 10 pre-programmed therapy profiles, with a lock feature to restrict edits.
See it with your team.
A side-by-side evaluation — in your unit or online — beats any brochure. Schedule a demo and our team will set it up.