Flutter a device for clearance of airway

Physio-therapeutic treatment device

1. FLUTTER- A DEVICE FOR AIRWAY CLEARANCE SHILPASREE SAHA MPT CARDIOTHORACIC DISORDER ROLL NO- 18188006

2. Oxygen transport or ventilation is the primary function of respiratory system. Several medical , surgical, environmental condition or some other factors may interfere this process. Normally 2lt of mucus is produced per day. Excess mucus in the airway may hamper the exchange of gases. Airway clearance technique is the technique of mobilization of secretion from airways in patients with impaired mucociliary clearance or an infective cough mechanism .

3. The FLUTTER is a respiratory device that produces an oscillatory positive expiratory pressure that can be used as an alternative for removal of secretion.

4. Flutter is a pipe like device, one way valve consists of: Mouthpiece Plastic cone Steel ball Perforated plastic cover

5. PRINCIPLES OF OPERATION: The principle of the Flutter as a mucus clearance device is based on its ability to: Vibrating the airway. Intermittently increase endobronchial pressure. Accelerate expiratory airflow.

6. FREQUENCY AND DURATION Flutter therapy is more goal based, than time based therapy & experience has shown successful clearing of airways for most patient will occur in approximately 5-15 minutes. Use of flutter thrice a day is usually recommended.

7. INDICATION Cystic fibrosis Emphysema Bronchitis COPD Atelectasis Bronchiectasis Asthma

8. CONTRAINDICATION Pneumothorax Haemoptysis Acute right sided heart failure

9. RESEARCH FINDINGS:

10. BENIFITS Loosens trapped mucus. Keep the airway open. Triggers patients to cough which relieves the mucus from lungs.

11. DISADVANTAGE Costly. It can be broken if not handled carefully.

12. CLEANING THE FLUTTER The FLUTTER is recommended for single patient use only. Instruct patients to clean the FLUTTER after each session to remove moisture and/or mucus. In every two days, patients should disassemble and clean their FLUTTER in a solution of mild soap or detergent. Chlorine bleach or other chlorine-containing products (e.g., dishwashing detergent) should not be used. Rinse, dry, reassemble, and store.

13. PRECAUTIONS The steel ball within the FLUTTER, if separated from the FLUTTER, could pose a choking hazard. The FLUTTER must be handled carefully; it may break if dropped on a hard surface.

14. CONCLUSION Flutter is a hand held device that can be recommended for home based protocol after giving proper training to the patient. It will help to reduce the physical effort & focus more on mechanical effort to remove secretion.

15. Reference: 1. Konstan MW, Stern RC, Doershuk CF. Efficacy of the FLUTTER® device for airway mucus clearance in patients with cystic fibrosis. J Pediatrics May 1994; 124:689-693. 2. Frownfelter D, Dean E,Principles and practice of cardio pulmonary physical therapy, third edition. 3. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised,controlled , cross-over trial .Tiffany J. Dwyer, Rahizan Zainuldin et al . Dwyer et al. BMC Pulmonary Medicine (2017) 17:14 4. Current devices of respiratory physiotherapy. Hristara – Papadopoulou A, Tsanakas J, Diomou G et al. HIPPOKRATIA 2008, 12, 4: 211-220 5. The Efficacy of Flutter ® and Active Cycle of Breathing Techniques in Patients with Bronchiectasis : A Prospective, Randomized, Comparative Study. Bilge Üzmezoğlu1, Gündeniz Altıa et al . DOI: 10.5152/TurkThoracJ.2018.17050

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