1. Best Practices in Lung Management Experiences using MetaNeb
Paula Abbas, BSN, RN, CPTC LifeSource Donation Coordinator Region 7 Meeting February 13, 2015

2. Current options for CPT
Metaneb 4.0
Vest therapy CPT
Manual CPT

3. 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

4. The MetaNeb® System Description
4/15/2017
The MetaNeb® System Description
The 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:
Continuous Positive Expiratory Pressure (CPEP)
Lung expansion therapy for the treatment and prevention of pulmonary atelectasis
Continuous High Frequency Oscillation (CHFO)
Secretions mobilization therapy
Aerosol Mode
Aerosol Therapy
Provides supplemental oxygen when used with compressed oxygen
The MetaNeb System is a therapeutic device, available in acute care settings, which uses a systematic approach to enhance secretion clearance and resolve or prevent patchy atelectasis.
The three therapies provided within A MetaNeb Treatment include:
CHFO Therapy, which stands for Continuous High Frequency Oscillation and provides secretion clearance
CPEP Therapy, which stands for Continuous Positive Expiratory Pressure, and provides lung expansion therapy
Aerosol Therapy, which is continuously delivered in any of the modes
It also provides Supplemental oxygen when connected to your 50 psi oxygen gas source

5. Absolute Contraindications
The MetaNeb® System
Absolute Contraindications
Untreated tension pneumothorax
Untrained or unskilled operator
There are absolute contraindication for airway clearance which are listed
And for the MetaNeb System which are listed
We have listed some relative contraindications specific to the MetaNeb System
These reflect conditions that should cause pause since it is a prescription device the physician must weigh the benefit against any risk to the patient.

6. 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

7. 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.

8. 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.

9. 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

10. 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

11. Questions?