Smiths Medical Acapella Vibratory PEP Therapy System

Smiths Medical Acapella Vibratory PEP Therapy System

Brand/Manufacturer: SMITHS MEDICAL
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  • HyGiene Products

Smiths Medical Acapella Vibratory PEP Therapy System combines the benefits of both PEP therapy and airway vibrations to mobilize pulmonary secretions. It can be used in virtually any position allowing patients to move freely and sit, stand or recline. Acapella inhaler facilitates opening of airways in patients having lung diseases with secretory problems such as COPD, asthma and Cystic Fibrosis. It gives independence to patients with chronic respiratory diseases as the therapy can be done when convenient for the patient and without the need for an assistant.

Acapella PEP Therapy System Highlights

  • Clears airways of secretions
  • Improves bronchial hygiene
  • Accommodates virtually any lung capacity
  • Comes in color-coded units
    - Green for high flow
    - Blue for low flow

Item # Desc Pkg Price
21-1530 DH with Mouthpiece, High Flow, Green Each
21-1015 DM with Mouthpiece, Low Flow, Blue Each
21-1015 + 21-1530 Acapella Blue (1) + Acapella Green (1) Therapy System Each
21-1015 DM with Mouthpiece, Low Flow, Blue 10/Case
21-1530 DH with Mouthpiece, High Flow, Green 10/Case

Acapella Vibratory PEP Therapy System Features

  • Allows inhalation and exhalation without removing from mouth
  • Prolongs expiratory airflow to increase removal of secretions
  • Allows use with mask or mouthpiece attachment
  • Allows use with inline nebulizer when fitted with tee adapter
  • Color-coded units help customize treatment for each patient based on their clinical needs
  • Frequency and flow resistance of Acapella breathing device can be adjusted by turning an adjustment dial
  • Can be used in any position - patient is free to sit, stand or recline
  • Easier to tolerate than Chest Physical Therapy (CPT)
  • Takes less than half the time of conventional CPT sessions
  • Acapella Blue-DM <15 lpm for 3 seconds
  • Acapella Green-DH >15 lpm for 3 seconds
  • 22mm OD ambient end
  • 22mm OD patient end
  • Patented rocker mechanism
  • Single patient use device

Benefits of Smiths Medical Acapella Vibratory PEP Therapy System

  • Allows inhalation and exhalation without removing from mouth 
  • Prolongs expiratory airflow to increase removal of secretions 
  • Allows use with mask or mouthpiece attachment 
  • Allows use with inline nebulizer when fitted with tee adapter
  • Accommodates virtually any patient’s lung capacity
  • Can be used in any position - patient is free to sit, stand or recline

Acapella Therapy System consists of:

  1. Removable mouthpiece
  2. Acapella Vibratory PEP Device with 22 mm male fittings including:
    A. Expiratory resistance/frequency adjustment dial
    B. One-way inspiratory valve
    C. Patient end which adapts to a mouthpiece, or mask
    D. Mouthpiece (detachable)

How does the Acapella Device work?

Acapella by Smiths Medical directs exhaled air through an opening which is periodically closed by a pivoting cone. As air passes through the opening, the cone alternately closes and opens the air flow path. The result is a vibrating pressure waveform. For most users, frequencies between 0-30 Hz are obtained while maintaining positive pressure throughout the exhalation process. This is referred to as vibratory PEP therapy.

Through adjusting the dial, the frequency of the vibrating pressure-waves and the resistance of the opening changes.

Acapella Vibratory PEP Therapy System User Guide

When to use Acapella Respiratory Device?

  • Acapella is intended for use as a single patient use device that provides Positive Expiratory Pressure (PEP) Therapy for patients who have Cystic Fibrosis, COPD, asthma, and lung diseases with secretory problems, and patients with atelectasis.
  • It may also be used simultaneously with nebulized aerosol drug delivery.
  • Green: Acapella DH is recommended for patients able to maintain an expiratory flow of 15 liters per minute or greater for 3 seconds.
  • Blue: Acapella DM is recommended for patients capable of less than 15 liters per minute for 3 seconds.

Contraindications -


Although no absolute contraindications to the use of PEP Therapy have been reported, the following should be carefully evaluated before a decision is made to initiate therapy:


  • Inability to tolerate increased work of breathing
  • Known or suspected tympanic membrane rupture or other middle ear pathology

How to use Acapella Vibratory PEP Device?

Initial Settings -


  1. If this is the first use of Acapella DM & DH Vibratory PEP Therapy System, ensure that frequency adjustment dial is turned counterclockwise to lowest frequency-resistance setting.
  2. Instruct the patient to relax while performing diaphragmatic breathing and inspiring a volume of air larger than normal tidal volume (but not to total lung capacity).
  3. Direct the patient to exhale to functional residual capacity (FRC) actively, but not forcefully through the device.
  4. The patient should be able to exhale for 3-4 seconds while the device vibrates. If the patient cannot maintain an exhalation for this length of time, adjust the dial clockwise. Clockwise adjustment increases the resistance of the vibrating orifice, which will allow the patient to exhale at a lower flow-rate.
  5. Selection of the proper resistance range produces the desired inspiratory to expiratory (I:E) ratio of 1:3 to 1:4.
  6. Note: If the desired resistance and I:E ratio cannot be achieved, consider use of an Acapella device designed for alternate flow ranges.
  7. Once the proper range has been identified, the patient may be instructed to exhale harder or softer, or dial adjustments may be made to optimize the response the user feel from the vibratory pressure.
  8. Several uses may be needed to ensure that the individual patient needs are being met.

Procedure for the User -



  1. Ensure the adjustment dial is set to correct range as identified by your clinician.
  2. Sit with elbows resting comfortably on table.
  3. Place mouthpiece lightly in mouth.
  4. Be sure to maintain a tight seal on the mouthpiece during exhalation.
  5. Your clinician may recommend the use of a nose clip if necessary.
  6. If using a mask, apply mask tightly but comfortably over nose and mouth.
  7. Breathe from the diaphragm, as directed by your clinician, taking in a larger than normal breath, but not filling your lungs to capacity.
  8. Hold your breath for 2-3 seconds.
  9. Exhale actively, but not forcefully, through the device. Exhalation should last approximately 3 to 4 times longer than inhalation.
  10. Perform 10-20 PEP breaths as recommended by clinician. Remove mouthpiece and perform 2-3 huff coughs to raise secretions as needed. Your clinician may direct you on proper cough technique.
  11. Repeat steps 2 to 7 as prescribed.

Cleaning instructions -
As needed, detach mouthpiece then soak the parts in warm soapy water, rinse and dry. Drain the device by placing the unit with the mouthpiece end downward, or by resting the unit on its side.

Estimated Device Lifetime -
Assuming the manufacturer recommended cleaning protocol is followed, the Acapella device should have a useful life of six (6) months under normal and customary usage. The six (6) month usage duration is measured from the date of initial use.






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