You coach the patientthis is a spontaneously breathing patient who is coherent enough to walk through the therapy with youyou encourage on the deep breathing mode, the CPEP mode, you start them there and stay there for a couple of minutes, and then you switch over to that oscillatory mode, CHFOwhich starts to percuss in those recruited airways to bring up those secretions, while the nebulizer is running consistently, Mellor said. NOTE: There is no need for CPEP as this therapy can be accomplished with the ventilator. Between Metaneb and IPV there have been no studies to show significant differences. (2020). It consists of a pneumatic compressor that delivers OLE therapy using both continuous high-frequency oscillation (CHFO) and continuous positive expiratory pressure (CPEP). Intrapulmonary percussive ventilation (IPV) devices have been in use for more than 25 years and are used widely in the acute care, post-surgical, and homecare setting. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of WTWH Media. Weighing only 9 lbs, the CoughAssist T70 is easily portable, and a detachable battery adds a new level of flexibility for patients and caregivers. PEP (EzPAP, MetaNeb) is performed if patient is: Unable to perform IS-or- Not meeting incentive spirometry goal or Has persistent or severe atelectasis or Has poor oxygenation Induced deep breathing in patients with a tracheostomy Indications and frequency in the VEP - the RT will assess patient and assign them a RT Triage Score. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of WTWH Media LLC. Radiological Society of North America. to 10ft. After 20 minutes, or when the cup is empty, the treatment is complete. Youre really facilitating it in a physical and a physics type treatment delivering that oscillatory breath across the area of the secretion, thinning it down where it can be expectorated by the patient.. Use of The MetaNeb System will follow the labeling of the device. If performing with an artificial airway, deflate the cuff slightly during therapy remembering to re-inflate after therapy is completed. 0000010608 00000 n Efficacy of oscillation and lung expansion in reducing postoperative pulmonary complication. 0000024074 00000 n 0000003127 00000 n Together, these quality improvements may lead to reduced hospital expenditures and better value-based care for this patient population.. J Am Coll Surg. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02627742. https://assets.hillrom.com/is/image/hillrom/MetaNeb_ai0444_0078_shadow?$recentlyViewedProducts$, /en/products/request-more-information/?Product_Inquiry_Type=More%20Information&I_am_most_interested_in=Non-Invasive%20Respiratory%20Therapy&Product_Name=MetaNeb_System, hillrom:care-category/non-invasive-respiratory-therapy, hillrom:sub-category/therapy-oscillation-lung-expansion,hillrom:care-setting/acute-care, https://www.hillrom.com/en/products/the-metaneb-system/#overview-0, https://www.hillrom.com/en/products/the-metaneb-system/#educationdocumentation-1, MetaNeb System Controller close-up, front facing, An older patient in a hospital bed receives therapy from the MetaNeb system, his clinician nearby, A clinician with a gloved hand adjusts a control knob on the MetaNeb System Controller, A clinician with a gloved hand adjusts the MetaNeb Circuit, patient in background, A clinician connects the MetaNeb system to administer therapy to a patient who has been intubated, A clinician with gloved hands connects the MetaNeb system for use with ventilation, A young patient in a hospital bed receives therapy from the MetaNeb system, with help from her clinician, Chronic Obstructive Pulmonary Disease (COPD), Patients who need Post Operative Airway Management, Patients who need Emergency Room Airway Management, Introduces continuous high-frequency oscillation (CHFO) therapy immediately after lungs have been expanded through continuous positive expiratory pressure (CPEP), Integrates aerosol delivery of medications for maximum efficiency. The device can be used in treating patients with a number of respiratory diseases and conditions, including cystic fibrosis and COPD. Philips Respironics CoughAssist T70 is a second-generation manual insufflator/exsufflator, which the company introduced to the market approximately 1 years ago. Spinal surgery involving a posterior approach Surgery for organ transplant Chronic invasive positive pressure ventilation (PPV). al. Set the operational pressure (which controls the peak operational pressure) between 30-45. Indications would be worsening oxygenation, increasing FIO2 and/or PEEP, evidence of lung collapse or mucus plugging, and/or retained pulmonary secretions in the absence of an effective cough. Draining and monitoring of cerebrospinal fluid (CSF) flow from the lateral ventricles or lumbar subarachnoid space is indicated in selected patients to: Reduce intracranial pressure (ICP), eg, pre-, intra-, or postoperative. While oscillating technology is essential to secretion clearance, RTs and other clinicians have a number of options for the way it can be done, as the following representative devices from Hill-Rom, Philips Respironics, Electromed, and Monaghan Medical Corp illustrate. Pathology can be described as a respiratory disease that often progressed into pneumonia with bilateral ground-glass opacities. To watch the webinar, follow the link below to register, and you will receive a link to view the video. 0000011442 00000 n Save my name, email, and website in this browser for the next time I comment. MedTech 100 is a financial index calculated using the BIG100 companies covered in We have designed our system to maximize the comfort and assure that it is easy to use, said Kathleen Skarvan, CEO of Electromed. (2018). Lei, J., Li, J., Li, X., & Qi, X. Al(C0. According to Skarvan, the device has been prescribed to patients ranging in age from newborns to senior citizens. As with the MetaNeb, the SmartVests oscillations thin the mucus and then propel it to the larger airways where it can be expectorated or coughed out. Risk Assessment for and Strategies To Reduce Perioperative Pulmonary Complications for Patients Undergoing Noncardiothoracic Surgery: A Guideline from the American College of Physicians. Mellor of Hill-Rom noted that ultimately its a question of finding a provider that offers a quality product and stands behind it. 189 0 obj <>/Filter/FlateDecode/ID[<087C52A1184D40B4B8A759C2FEB6BFAB>]/Index[165 49]/Info 164 0 R/Length 112/Prev 857759/Root 166 0 R/Size 214/Type/XRef/W[1 3 1]>>stream Another modality option is Metaneb. These therapies carry similar risk of airborne transmission. The continuous mist helps hydrate secretions allowing for the facilitation of trapped sticky mucus. However, it does work on the same principle of using oscillations to thin and dislodge mucus in the patients lungs. Therapy with the MetaNeb. endstream endobj startxref hVn6l1d'R$E[`Z.`$*Dq~w&:$:>E,b|qO4A3 The MetaNeb System, offered by Hill-Rom, addresses post-surgical respiratory problems that can impair a patients recovery. You have reached the maximum number of saved studies (100). The MetaNeb System, by mobilizing mucous secretions and lung expansion, may have contributed to these clinical improvement, Huynh says. The MetaNeb is designed for use on a number of patient types from postsurgery patients, such as thoracic or cardiac patients, to patients with chronic conditions or diseases such as cystic fibrosis or COPD. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. The MetaNeb System is indicated for mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis, and also has the ability to provide supplemental oxygen when used with compressed oxygen. The soft start helps people to better acclimate to the therapy so it doesnt give them an abrupt sharp hug, and the active inflate and deflate acclimates the patient to therapy by allowing the garment to contour to the chest cavity and the pulse amplitude remains more constant during the inhalation and exhalation so you dont have an uncomfortable bear hug.. 0000029883 00000 n hbbd```b``v /d-lW0yDy`DrEHQVV&@Z0; ArN2qL %1m 0000002608 00000 n 0000011922 00000 n interviewer says fair enough. The MetaNeb System is a device that delivers continuous highfrequency oscillation (CHFO) and positive expiratory pressure (CPEP) to facilitate pulmonary mucus clearance and provide lung expansion. Additional interests are ventilators, new innovations in healthcare, and traveling. . Learn more about MetaNeb System. The guidelines related to airborne precautions, provided by the CDC should be followed when delivering the therapy.5, Efficacy of Oscillation and Lung Expansion in Reducing Postoperative Pulmonary Complication, Learn how to reduce the length of stay for pneumonia patients. Provide temporary CSF drainage in patients with infected . Health care providers must therefore take the same precautions5. Higher. 2019;229(5):458-466. According to Egans, comparative studies show that IPV is equivalent to other airway clearance strategies in improving short term pulmonary function tests results enhancing sputum expectoration in patients with cystic fibrosis. Please remove one or more studies before adding more. DeviceTalks is a conversation among medical technology leaders. Device: MetaNeb System Detailed Description Post-operative pulmonary complications (PPC) are associated with significant excess morbidity, mortality and healthcare expenditure. While the MetaNeb is currently only for use in hospital settings, Mellor said that the long-term goal is for the device to be offered for home use. outcomes data with the MetaNeb System, the intended use of MetaNeb System therapy is for lung expansion and secretion clearance treatments regardless of etiology. Paul, MN 55126, PatientsImportance of Respiratory HealthManage My TherapyProductsPatient Stories, Healthcare ProfessionalsBreak the Vicious CycleManage My PatientsProductsVA Government Options, ResourcesVideo LibraryEducation OptionsReimbursement ServicesInsurance CoverageGlossary of Terms, About UsInnovation MilestonesOur VisionCustomer ServiceIn the NewsEvents, Privacy Policy | Terms of Use | HIPAA Notice of Privacy Practices. 0000028340 00000 n As with all therapies, the appropriateness of the therapy in individual patients is determined by the treating physician and the health care team. Among the specific conditions that can see benefits are patients with neuromuscular diseases, ALS, or any illness that prevents them from adequately expectorating secretions, and who are at an increased risk for developing respiratory infections. The therapy may therefore be helpful in preventing and/ or treating such complications. Learn more about the Center of Disease Control and Society (CDC) of Critical Care Medicine (SCCM) guidelines. Learn how your comment data is processed. Journal of burn care & research : official publication of the American Burn Association, 34(2), e112e115. OLE therapy delivered by The MetaNeb System helps expand the lungs and mobilize secretions using Continuous Positive Expiratory Pressure (CPEP), and Continuous High Frequency Oscillation (CHFO). The device was put to the test in a study performed at the Robarts Research Institute, Western University, London, Ontario, and researchers found that the study subjects had improvements in increased mucus clearance, decreased cough frequency and breathlessness, and enhanced exercise tolerance. 495 0 obj <>/Filter/FlateDecode/ID[<1742E9C112FBC5499E861B44C2B66805><4050128B81A18744A2B46EC044BDCEFD>]/Index[472 38]/Info 471 0 R/Length 110/Prev 216860/Root 473 0 R/Size 510/Type/XRef/W[1 3 1]>>stream 2019 Nov;229(5):458-466.e1. It is designed to maximize treatment by combining three therapies in onevolume expansion, secretion clearance, and nebulizer therapy. Get in the know to get the most value out of your solution. The treatment protocol used for Respiratory Care during the CHANGE IN PRACTICE period of the Study will be that prescribed by the patient's health care team in the routine standard care of each patient. scopic" procedure. Contact a Respiratory Health representative for more information, Advanced Respiratory, Inc. A Hillrom Company1020 County Road F WestSt. WTWH Media LLC and its licensors. Kacmarak, R., Stroller, J., Heuer,A. Retrieved from. Many of these patients are spontaneously breathing, so are able to work directly with the RT. If the SmartVest is prescribed for home use, a trainer will be sent to the patients home to help them be fit with the device and understand how it is used, and to calibrate it according to the prescribing physicians directions. View Product Details Contact a Respiratory Health representative for more information Call us at (800) 426-4224 or 0000007907 00000 n https://doi.org/10.1097/BCR.0b013e318257d83e. 27 0 obj <> endobj xref 213 0 obj <>stream Listing a study does not mean it has been evaluated by the U.S. Federal Government. Monitor CSF chemistry, cytology, and physiology. 0000001441 00000 n Post-operative pulmonary complications (PPC) are associated with significant excess morbidity, mortality and healthcare expenditure. The Matter of Pressure- ETT Cuff Pressures, Catecholaminergic Polymorphic Ventricular Tachycardia: Recognize And Treat It Early, 4Ts versus 3Ls: heparin induced thrombocytopenia probability scoring, Docusate for Cerumen Impaction? View this study on Beta.ClinicalTrials.gov. If done in line with ventilation then the clinician can leave fragment in the CHFO mode. 2021 Hill-Rom Services PTE Ltd. ALL RIGHTS RESERVED. Demographic, clinical & outcome data will be collected for eligible patients during the two stages of the study. The MetaNeb System combines lung expansion, secretion clearance, and aerosol delivery into a single integrated therapy sessionwithout having to switch between different devices. Its really about coaching the patient on the deep breathing piece, explaining that theyre going to get percussedso they know theres some secretion clearance that will be going on. With the MetaNeb, you can seamlessly switch between recruiting an expansion of the lung, which is ultimately what patients need, to take a deep breath, through CPEP, and transition over to CHFO and pull those secretions from that expanded air space and clear their lungs, Mellor said. 2 . endstream endobj 473 0 obj <. The SmartVest is also used in acute care settings, where it is administered by RTs. 0000027706 00000 n This is a non-randomized facility (or hospital) level pre-post intervention study. The MetaNeb System is indicated for mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis, and also has the ability to provide supplemental oxygen when used with compressed oxygen. 0000028659 00000 n 0000003954 00000 n %PDF-1.6 % Learn more about MetaNeb System. Huynh, Toan; Cereda, Maurizio; Diette, Gregory; Liesching, Timothy 0000023728 00000 n Information provided by (Responsible Party): To determine if a therapy regimen including treatment with The MetaNeb System has a positive impact on the rate of pulmonary complications that occur in high risk post-operative patients. Wolski is a contributing writer to RT magazine. Patient Requires Prolonged Mechanical Ventilation, Patient requires prolonged respiratory support for > 24 hours post-surgery, Diagnosis of Pneumonia Within Seven (7) Days, Readmission to ICU (or transfer to an elevated level of care) for pulmonary complications within seven (7) days of discharge. 0000034614 00000 n @2020 - All Right Reserved. The MetaNeb from Hill-Rom is currently only available to clinicians as an in-hospital device. (2020). The possible complications listed below: Over distention of air sucks (alveoli). 0000005309 00000 n Metaneb is utilized for mobilization of secretions, lung expansion, and can be used for the prevention and treatment of atelectasis. In the event of having a patient who presents with any of the above-mentioned situations along with having a traumatic injury such as broken ribs, chest tubes, or low tolerance for other modalities, two modalities present themselves as an option; one being IPV. All rights reserved. Qaseem A, et al. The use of oscillatory therapy also helps promote lung expansion, No major difference has shown between choosing over the other as the method of therapy, Both therapies have shown to be helpful in patients with chest wall complications. Explore Hillrom's products and medical technologies across the health care industry. 0000027969 00000 n and can be impacted by environmental factors such as velocity and mechanism by which respiratory droplets are propelled from the source, the density of respiratory secretions, environmental factors such as temperature and humidity, and the ability of the pathogen to maintain infectivity over that distance2and therefore has the potential to become an aerosol or airborne. 0000006582 00000 n Care should be taken when doing any AGP (including The MetaNeb System therapy) in patients with COVID-19. 0000014570 00000 n A variety of strategies have been shown to reduce the risk for development of post-operative atelectasis including lung expansion (LE) therapies. Atelectasis and secretion retention in combination are major risk factors for those prone to alveolar collapse such as those with muscular weakness, patients on ventilators, and the pediatric population. It delivers a rapidly repeating pulse of air alternately squeezing and releasing the upper bodyeach squeeze simulates a mini cough, which acts to loosen the mucus from the walls of the airways. Recent layoffs, retrenchment may signal difficult times lie ahead. The device used in the study was The MetaNeb System (Hill-Rom). The results demonstrated that incorporating MetaNeb therapy led to a significant reduction in postoperative pulmonary complications, less time on mechanical ventilation, and reduced hospital length of stay.. hb``e``eg`e`Pd`@ j5y```RRh``6h 1@Z"|_'10^. A 2015 study published in Expert Review Respiratory Medicine indicated that PPCs might beset post-surgical patients at ratea as high as 40 percent, emphasizing the benefit of taking a proactive approach. 2014:1-11. 0000041216 00000 n Expanded Medicare coverage for CGM to go into effect next month, Bigfoot Biomedical wins FDA clearance for Bigfoot Unity Android app, Vivani Medical wants to bring a subdermal drug delivery implant to the diabetes market, Eli Lilly is cutting the price of insulin by 70%, SonoThera licenses GE HealthCare microbubbles for guided gene therapy delivery, Subscribe to Drug Deliverys E-Newsletter. Read full description Request More Information Overview Education & Documentation Overview At the same time, the nebulizer is running throughout the entire therapy session. I think it is important to note that a large majority of that therapy relies on that expansion to get that air space opened up.. 165 0 obj <> endobj The device begins by offering continuous positive expiratory pressure (CPEP) therapy, which helps expand the lungs, and then seamlessly moving on to the secretion clearance part of the treatment, which the company refers to as continuous high frequency oscillation (CHFO) therapy, at regular intervals. Indications would be worsening oxygenation, increasing FIO2 and/or PEEP, evidence of lung collapse or mucus plugging, and/or retained pulmonary secretions in the absence of an effective cough. The MetaNeb Systems simple connect and go design uses single patient use circuits that includes a mouthpiece and adaptors for a face mask, tracheostomy, and in-line ventilation. doi: 10.1016/j.jamcollsurg.2019.06.004. Droplets are considered particles secreted from a patients respiratory tract that are no smaller than 5m in diameter and travel shorter distances (defined as 3ft) because they cannot stay suspended in air for long periods of time. %%EOF doi: Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, Ferguson, N. M. et. 509 0 obj <>stream I would think this would be an inexpensive and easy in home alternative to a metaneb or IPV. Improve respiratory status and reduce pulmonary complications 1,2; The Vest Airway Clearance System and The MetaNeb System provide therapy using single patient use disposable wraps and circuits. (2013). Patients who may benefit from The MetaNeb System include those with pulmonary atelectasis or secretions associated with the following conditions: *Therapy times may differ depending on patient needs and ordered therapies. Evaluation of The MetaNeb System to Reduce Postoperative Pulmonary Complications Latest version (submitted September 11, 2017) on ClinicalTrials.gov A study version is represented by a row in the table. 0000024296 00000 n The SmartVest is designed to acclimate the patient to its use. MetaNeb Therapy Effective: 07/20/2018 Revised: Continued next page MetaNeb Therapy Purpose The Meta Neb System facilitates mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis and also has the ability to provide supplemental oxygen when used with compressed oxygen. The MetaNeb System Three therapies. Study record managers: refer to the Data Element Definitions if submitting registration or results information. System to a 50 psi oxygen source. CT Imaging of the 2019 Novel Coronavirus (2019 . position. Attention: Not all products/options are available in all countries. With new emphasis on reducing and preventing hospital readmissions as a result of the Affordable Care Act, secretion clearance will undoubtedly play a key role in keeping patients from making repeat hospital visits. CPEP mode provides aerosol combined with continuous positive pressure helping with lung expansion. Epub 2019 Jul 27. Retrieved from, https://www.hillrom.com/en/products/the-metaneb-system/, Ortiz-Pujols, S., Boschini, L. A., Klatt-Cromwell, C., Short, K. A., Hwang, J., Cairns, B. Similar to the IPV, Metaneb employs the same type of High Frequency Oscillatory action. Alternating between the cycles of CPEP and CHFO helps maximize therapy effectiveness when combined with aerosol therapy. As a result, the CoughAssist T70 is a more gentle, comfortable way to remove secretions, keeping airways clear longer than trached suction and with fewer complications, Diacopoulos said. Patients will receive standard care with the addition of therapy with The MetaNeb System. 144, 575-580. IPV promotes mobilization of secretions, provides nebulized therapy, and provides intrathoracic vibration and percussion, thus improving ventilation. 0000024185 00000 n Elderly patients and those with underlying conditions like hypertension, cardiovascular disease Like most modalities, Chest Physiotherapy is not only dependent on the practitioner performing it but the patients willingness to have it done and work with the practitioner. The MetaNeb is designed for use on a number of patient types from postsurgery patients, such as thoracic or cardiac patients, to patients with chronic conditions or diseases such as cystic fibrosis or COPD. The 10-minute timeframe isnt arbitrary, since most nebulizer treatments run about that duration, Mellor noted. 11. hb```B eaq]w,y{9 Y :Y-P%?: - CHFO is the oscillatory mode sending pulsations into the airways. Although SARS-CoV is transmitted primarily by contact and/or droplet routes, airborne transmission over a limited distance (e.g., within a room), has been suggested, though not proven.3. This can be performed in quite a number of ways dependent upon the patient, the lobe that requires the therapy, and any contraindication that can prevent a certain method of therapy. I Sh*t You Not, Adrenal Crisis: Early Recognition and Management Save Lives, Prehospital Management of Traumatic Brain Injury, Differentiating Peak and Plateau Pressures, Sodium Bicarbonate for cardiac arrest: Time to put it away. Age 18 years Post-thoracic, -upper abdominal or -aortic surgery Open surgical procedure Incision at or above the umbilicus. However,SARS-CoV while still classified as a droplet, is estimated to travel anywhere from 6ft. Connect the MetaNeb. 0 10 Minutes Total*: Alternating cycles of CPEP and CHFO combined with aerosol delivery helps maximize therapy effectiveness. https://doi.org/10.1148/radiol.2020200236, https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html, https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf, https://doi.org/10.1016/S0140-6736(20)30183-5, https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html, Wear appropriate personal protective equipment (PPE) including, but not limited to an N95 fit tested respirator, gown, gloves, and face shield/eye protection, Follow cleaning and disinfection procedures promptly in guidance with hospitals protocols, Refer to facility specific Infection Control guidelines for full recommendations. As discussed in chest physiotherapy Part 1, CPT is a modality commonly utilized by respiratory therapists in patients in whom the chest x-ray reveals focal lung opacity, evidence of retained secretions, and/or ineffective cough. Chest high-frequency oscillatory treatment for severe atelectasis in a patient with toxic epidermal necrolysis. hb```c````e`jab@ !G#b.S.KusL7X:b6K*}z:q[hG[jAH60mFl&@HGGZdx2+00OdZFUU5Ed83mePp'ຣ@ 3I Set CPEP 10-30 based on patient tolerance. 472 0 obj <> endobj Set mode to CPEP. Philips Respironics also has clinical experts available for in-service training sessions, as well as product support for clinicians and patients. 0000026299 00000 n One device. Although PPCs are an incompletely understood multifactorial syndrome, atelectasis is recognized as a critical component. In Stage I of the study, a retrospective review of medical records for post-surgical patients, who received STANDARD THERAPY as defined by current hospital and respiratory care department policies and procedures will be performed. 0000001176 00000 n The Your email address will not be published. Put the master switch in the . And you take time to switch back and forth.. 10. Technology changed all that. A lung-expansion therapy, MetaNeb enhances mucus clearance and helps resolve or fully prevent patchy atelectasis. For further information, contact [emailprotected]. Metaneb has a fixed orifice while IPV has a sliding venturi which facilitates the oscillations. This surgical robotic arm could 3D bioprint inside the human body, Medtechs top R&D spenders and the projects they launched, How Penumbras smart-sucking algorithms and catheters speed up clot removal, IBS researchers develop high-resolution ultra-thin endoscope. Earlier this year, the Aerobika received the Gold award at the Medical Design Excellence Awards (MDEA). Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number): Why Should I Register and Submit Results? The journey of care isnt over for patients once theyre wheeled out of the OR. The MetaNeb System is indicated for mobilization of secretions, lung expansion therapy, the treatment and prevention of pulmonary atelectasis, and also has the ability to provide supplemental oxygen when used with compressed oxygen. Metaneb like IPV can be done via mouthpiece, artificial airway, and in-line with the ventilator. PURPOSE: The management of pulmonary complications of patients with chronic debilitation conditions such as cerebral palsy . Infection Bloody sputum (hemoptysis) Pulmonary Complications in High-Risk Patients 2/26/2018 CHICAGO , Feb. 26, 2018 /PRNewswire/ -- A group of researchers have reported that aggressive treatment after surgery using the Hill-Rom MetaNeb System may reduce the incidence of post-operative pulmonary complications (PPCs) in high-risk surgical patients.