Protocol

Indications

  • Reduced Peak Cough Flow (pcf) < 270 lpm necessary to clear bronchial secretions during an infection
    • PCF can be measured by pneumotach or by simple peak flow meter adapted to a facemask.
  • A maximum expiratory pressure < 60 cm H20

Contraindications

  • Any patient with a history of bullous emphysema
  • Susceptibility to pneumothorax or pnuemo-mediastinum
  • Recent barotrauma, should be carefully considered before use

The above contraindications should be carefully considered before use.

Pegaso Cough Implementation

Attach Pegaso Cough user circuit to the Pegaso Cough output including a bacterial/viral filter, smoothbore tubing and an appropriate interface: mask or trach adapter. If a mask is used, it should be of appropriate size to provide for a tight seal.
Begin with inspiratory pressures between +10 and +15 cm H20 and expiratory pressures of between -10 and -15 cm H20 to allow an introduction / acclimation period to the device.
Verify initial pressures or any changes in pressure requirements by occluding the circuit in a clean manner and cycling from inhale to exhale.

  • This should be done several times while viewing the pressure gauge

 Settings and Modes

 Will provide

 

Treatment Length and Process

  • A standard treatment consists of applying 4-6 consecutive cycles of insufflation/exsufflation.
  • Visible secretions should be removed via suction from mouth, tracheostomy tube or tubing.
  • The user should then rest for 20-60 seconds and return to their normal mode of ventilation and prescribed oxygen flow if needed.

Using with a Tracheostomy

  • Pegaso Cough treatment can be applied through a tracheostomy tube by using a 15 mm trach adaptor or by adapting to inline suction catheter that would allow for easy removal of secretions from the trach tube.
  • Higher exhale pressures may be required to overcome the increased resistance of a tracheostomy or endotracheal tube.
  • When treating with the Pegaso Cough through a trach tube, it is advisable to use a means for trapping any secretions that may potentially accumulate in the treatment circuit.
    • Standard water traps, sputum traps, or extension tubing with corrugated inner walls can serve well for this purpose.
 

 

Contact Porta-Lung, Inc. • 747 Sheridan Blvd, Unit 6 D • Lakewood, CO 80214 • 303-288-7575 • Fax: 303-288-7577