Best Practices in Lung Management

Experiences using MetaNeb Paula Abbas, BSN, RN, CPTC

LifeSource Donation CoordinatorRegion 7 MeetingFebruary 13, 2015

Current options for CPT

Metaneb 4.0

Manual CPT

Vest therapy CPT

Downfalls of manual and vest CPT

• Time consuming (manual)• Often not performed correctly or frequently

enough• Vest stays on patient, potentially interfering with

other treatments • Disturbing to families/seen as violent (vest)• Limited to loosening secretions

The MetaNeb® System DescriptionThe MetaNeb® System is a therapeutic

device that uses a systematic approach to enhance mucus clearance and resolve or

prevent atelectasis.

The MetaNeb® System offers 3 therapies:1. Continuous Positive Expiratory Pressure (CPEP)

– Lung expansion therapy for the treatment and prevention of pulmonary atelectasis

2. Continuous High Frequency Oscillation (CHFO)– Secretions mobilization therapy

3. Aerosol Mode – Aerosol Therapy

• Provides supplemental oxygen when used with compressed oxygen

The MetaNeb® System

Absolute Contraindications

‒Untreated tension pneumothorax

‒Untrained or unskilled operator

LifeSource’s Experience Device became available through Hill

Rom in 2012/2013 and several hospitals in our region began using the device in 2013

Lifesource worked with Hill Rom rep and hospital RTTs to begin using the device on organ donors

Noted decreased atelectasis and better secretion removal with use

LifeSource Experience cont. Hill Rom rep came to LifeSource skills

day to demonstrate set up and use of Metaneb to clinical staff in 2014.

LifeSoure worked with Hill-Rom legal rep to set up an exclusive rental program for use at 2 of our donor hospitals. (for use exclusively for organ donors) Unusual rental circumstances for organ donors requiring daily rental rate.

LifeSource Experiences cont. The 2 hospitals with the rental agreements

LOVE the metaneb and are considering purchasing the equipment

RTTs verbalize use of this device has prevented escalation of care to oscillators or other High frequency ventilator modes.

Significant reduction of atelectasis and increase in secretion removal noted by staff, demonstrated by CXR improvement, better oxygenation, and decreased secretions.

LifeSource Experiences cont. Treatment not as violent as the vest.

Families not bothered by treatment Easy to use RTTs with overwhelming positive

feedback regarding device Research data available on Hill-Rom

website

LifeSource MetaNeb Protocol 10 minute treatment q 2 hrs Used with neb q 4 hrs, and q 2 hrs prn HOB up 30 degrees during treatment Used in conjunction with q 4 hr

recruitment maneuvers and O2 challenges

Used also in non-lung donors to improve oxygenation and secretion clearance

Questions?