PT - JOURNAL ARTICLE AU - Gabi Mueller AU - Ines Bersch-Porada AU - Sabrina Koch-Borner AU - Anja M. Raab AU - Marga Jonker AU - Michael Baumberger AU - Franz Michel TI - Laboratory evaluation of four different devices for secretion mobilisation: Acapella® Choice, green and blue versus water bottle AID - 10.4187/respcare.02654 DP - 2013 Sep 17 TA - Respiratory Care PG - respcare.02654 4099 - http://rc.rcjournal.com/content/early/2013/09/17/respcare.02654.short 4100 - http://rc.rcjournal.com/content/early/2013/09/17/respcare.02654.full AB - Background: Secretion removal is a key issue in patients with respiratory diseases and known to be most effective at vibration frequencies around 13 Hz and with the greatest amplitudes possible. The Acapella® devices and the water bottle are used for secretion removal in daily clinical practice but without detailed knowledge on optimal settings. The aim of this study was to evaluate the three different Acapella® devices and the water bottle at various settings and flows to determine the optimal device(s) and setting(s) for effective secretion removal. Methods: Three different Acapella® devices were tested at flows of 6, 12, 20, 30, 40 and 50 L/min and at all five settings. The water bottle was filled with 5, 10 or 15 cm of water and tested at flows of 3, 6, 10, 12 and 20 L/min. For all devices and combinations of settings, we measured the frequency and amplitude of the vibrations as well as the required pressure to generate vibrations. Results: Setting 4 was the best for all three Acapella devices, and the filling height of the water bottle shouldbe 5 cm. At these settings all devices elicited vibration frequencies between 12 and 15 Hz which is theoretically optimal for secretion mobilization. The resistance pressures of the devices to elicit these vibrations were between 5 and 11 cmH2O. However, the Acapella devices elicit higher vibration amplitudes (5 to 8 cmH2O) than the water bottle (1.8 cmH2O) Conclusion: Setting 4 was optimal for all three Acapella® devices. The Acapella® devices may be more efficient for secretion mobilization than the water bottle, because they elicit greater amplitude of vibrations.