A recent publication in Respiratory Care titled “In Vitro Comparison of Aerosol Delivery in High-Frequency Assisted Airway Clearance Devices With Integrated Nebulizers” presents new insights into how system design can influence aerosol delivery performance during airway clearance therapy.

The in vitro study compared two oscillating lung-expasion therapy (OLE) systems, BiWaze® Clear and Volara, under simulated adult breathing conditions, using standard settings for Positive Expiratory Pressure (PEP) and High Frequency Oscillation (HFO). Aerosol delivery was assessed using the system’s chosen integrated nebulizer.

Key Findings:

• BiWaze Clear delivered significantly more aerosol to the lung during both therapy modes.

  • PEP therapy: 28.0% (BiWaze Clear) vs. 6.2% (Volara) – P<.001

  • HFO therapy: 16.3% (BiWaze Clear) vs. 7.3% (Volara) – P=.005

• Volara exhibited high losses through the handset leak valve and fugitive emissions, suggesting greater inefficiencies in delivery.

The authors noted that the BiWaze Clear’s closed-circuit design and dual-lumen breathing circuit likely contributed to its improved aerosol deposition, helping reduce aerosol loss and optimize delivery.

“Circuit configuration and the type of nebulizer used may have a significant impact on aerosol delivery during high-frequency therapy.”
– Respiratory Care, Sept 2024

These findings support the importance of system design in maximizing therapeutic efficiency, particularly for patients who rely on precise and consistent aerosol delivery in combination with airway clearance therapy.

Read the full article in Respiratory Care:
https://www.liebertpub.com/doi/10.4187/respcare.11988