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ABM Respiratory Care Announces New Airway Clearance Device, the BiWaze® Clear System

We are excited to introduce BiWaze® Clear, a new airway clearance system that can be used in the hospital, post-acute, and home care environments. BiWaze Clear uses oscillating lung expansion (OLE) therapy to remove airway obstructions, mobilize retained secretions, and to prevent or treat atelectasis. It comes with a unique dual-blower system and a closed, vibrating mesh nebulizer for aerosol delivery. It saves time by expanding and clearing the airways in just 10 minutes, compared to other airway clearance therapies which can take up to 30 minutes. BiWaze Clear can be used to treat both acute and chronic respiratory conditions in the hospital, long-term care, and home environments.

OLE therapy is a treatment used to help clear secretions from the airways in people with respiratory conditions such as cystic fibrosis, bronchiectasis, and neuromuscular conditions. It has been utilized in the hospitals for over a decade and has been proven to be an effective airway clearance therapy. A recent study involving post-surgical patients demonstrated that OLE therapy decreased postoperative pulmonary complications by 31% and shortened the mean length of stay in the hospital by 1.6 days.1

The innovative BiWaze Clear system is portable and can be used anywhere, thanks to its lightweight and battery powered design. It delivers OLE therapy using a unique Dual Lumen Breathing Circuit™, which minimizes exhaled aerosol from escaping the handset or breathing tube until it is filtered by a coaxial bacterial/viral filter. BiWaze Clear delivers three therapies: lung expansion, high frequency oscillation, and nebulization with the Aerogen® Solo.

Internal vs. External Airway Clearance Therapy
To ensure effective airway clearance therapy, it’s crucial to choose a treatment that the patient can tolerate and maintain at home. High-Frequency Chest Wall Oscillation (HFCWO) therapy is considered the standard of care for airway clearance. This external therapy was expanded to a mobile solution (utilizing a wearable, battery-operated garment) ten years ago which has helped improve patient compliance in the home. For patients who struggle with HFCWO due to the tightly fitted garment or if they cannot tolerate the weight of a mobile garment, the BiWaze Clear system may be a better option.

BiWaze Clear’s OLE therapy is a breathing treatment which provides an internal therapy delivered via a patient interface (mouthpiece, face mask, or tracheostomy tube) instead of an external therapy like HFCWO. OLE therapy provides lung expansion using a set expiratory pressure to increase forced residual capacity, which can increase ventilation and open closed or blocked airways.1 OLE therapy also provides high-frequency oscillation where the system will vary the airflow to a set peak pressure to break up and thin mucus deep in the lungs. Medicated aerosol can be delivered to help calm inflamed airways and thin the mucus with the Aerogen® Solo nebulizer throughout the therapy.

BiWaze Clear’s therapy differs from IPV and IPPB because BiWaze Clear delivers positive expiratory pressure and high frequency oscillation therapy with an electronically controlled dual blower system. There is no venturi, no open exhalation port, and no jet nebulizer. BiWaze Clear has a dual lumen breathing circuit and a vibrating mesh nebulizer so the entire breathing circuit is closed. As a result, the patient’s exhaled breath is filtered by a coaxial bacterial-viral filter before entering the room air, ensuring a safer environment.

Historically, oscillating lung expansion (OLE) therapy systems faced challenges with aerosol deposition in the lungs due to the exhalation valve in the handset and the jet nebulizer in their breathing circuit design. BiWaze Clear was intentionally designed with two blowers controlling inhalation and exhalation separately through a Dual Lumen breathing tube. This unique design eliminates the need for an exhalation valve (completely closed handset) and includes a vibrating mesh Aerogen nebulizer. The research team at Seattle Children’s performed in vitro testing to evaluate the aerosol deposition of BiWaze Clear and compared it to a popular OLE therapy device, the Volara system.

Key Study Findings:

BiWaze Clear’s respiratory therapy is both efficient and adaptable, with an intuitive design that can be customized to meet each patient’s individual needs, promoting greater comfort and ease of use. To learn more about the exciting research, visit: BiWaze® Clear System – Evaluation of Aerosol Delivery in Vitro.

  1. Huynh TT, Liesching TN, Cereda M, Lei Y, Frazer MJ, Nahouraii MR, DieZe GB, Efficacy of Oscillation and Lung Expansion in Reducing Postoperative Pulmonary Complication, Journal of the American College of Surgeons (2019)
  2. DiBlasi, R, et al. (2023). BiWaze Clear Aerosol Comparison White Paper. Seattle Childrens Hospital and Research Institute. hZps://