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Thread: Since I started using the Minnesota Protocol 18 mos ago, FEV1 is up by 7%

  1. #1

    Since I started using the Minnesota Protocol 18 mos ago, FEV1 is up by 7%

    Hi all

    Just wanted to share the benefit of the Minnesota Protocol - a stepped system of varying air pressure and frequency in a Vest device. This has been proven to improve mucus clearance. For me, the most important points are to make the air pressure as high as you can comfortably tolerate and to do a good cough between levels.

    Since I started this (on the advice of UCSF Medical Center where I get my CF care) and since I stopped working, my lung function has gone from the mid 30s to the low 40s and is now about 42% of predicted for FEV1.

    Note: many CF care centers are ignorant of this method and fail to mention it to their patients.

    The following comes from Cincinnati Childrens Hospital and explains how to program your Hill-Rom (or other) vest

    http://www.cincinnatichildrens.org/h...sota-protocol/


    The Vest − Minnesota Protocol

    The standard protocol can be used with the following vest machines, Hill-Rom model 104 and newer, inCourage by RespirTech, and the Smart Vest.
    Setting a Starting Pressure for the Vest

    • If this is your child's first time using the vest, you will need to set up a Starting Pressure.
    • Set the Frequency to 8 Hz and the Pressure* to 6.
    • Press the ON button (or foot pedal).
    • After a minute or two of being on the vest, increase the Pressure to 7.
      • Give your child another minute or so to get used to this setting.

    • Keep increasing the pressure in this fashion until you reach the point where your child no longer feels comfortable, at which time you can back the pressure setting down by one.
      • The maximum pressure setting is 10.

    • Based on your child's comfort level you have now established the Starting Pressure, and are ready to being treatment.

    *Some vest machines will display pressures as a single number, double number, or a percentage (6, 60, or 60 percent).

    Instructions to Perform Treatment

    HIDE
    There will be six cycles of treatment. Each cycle uses a different frequency setting. Follow the steps below to complete your child's treatment.
    Setting the Machine for the First Cycle of Treatment

    1. Make the following setting on the machine:

    • Frequency = 8 Hz
    • Pressure = your Starting Pressure
    • Time = 5 minutes

    2. Press the ON button to begin treatment
    3. After five minutes of treatment, pause the vest generator to deflate the vest (if the vest does not deflate, disconnect one end of one of the hoses.)
    4. Perform two or three sets of Huff Coughs to remove mucus from your child's lungs.
    Note: During vest treatments, you will want to keep your child's airways moist by taking a nebulizer treatment during the entire time your child is on the vest. One way to do this is by filling your child's nebulizer cup with about 6-8 mL of sterile normal saline.
    Repeat steps 2 to 4 for remaining cycles.
    Setting the Machine for the Second to Sixth Cycle of Treatment

    You will do five more treatment cycles.

    • Each 5-minute cycle will have a different frequency setting and starting pressure
      • Cycle 2:
        • Frequency setting = 9 Hz
        • Starting pressure = Same as 1st treatment
        • Time = 5 minutes

      • Cycle 3:
        • Frequency setting = 10 Hz
        • Starting pressure = decrease setting by one
        • Time = 5 minutes

      • Cycle 4:
        • Frequency setting = 18 Hz
        • Starting pressure = decrease setting by 2/3 (see chart below)
        • Time = 5 minutes

      • Cycle 5:
        • Frequency setting = 19 Hz
        • Starting pressure = same as Cycle 4
        • Time = 5 minutes

      • Cycle 6:
        • Frequency setting = 20 Hz
        • Starting pressure = Same as Cycle 4 and Cycle 5
        • Time = 5 minutes


    Frequency Setting Pressure Setting
    If your starting pressure is:
    6 7 8 9 10
    8 and 9 Hz 6 7 8 9 10
    10 Hz 5 6 7 8 9
    18, 19, 20 Hz 4 5 5 6 7

    (Pressure settings are read from the Starting Pressure down)

    *Note: Some vest companies will display their pressure as a single number, double number or a percentage (6, 60, or 60 percent).




    Last Updated: 05/2013

  2. #2
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    THANK YOU SO MUCH! We weren't given very good details on what levels to do etc and that is awesome. Sending to our RTs for either their protocol or their "okay". And thanks for including the link to cinnicinati childrens so it is easier to pass on to RT and give it some credibility. Seriously...this is awesome guidance!

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