Baxter’s Volara OLE system improves CF and bronchiectasis patient care

Clearing the airways of cystic fibrosis (CF) and bronchiectasis patients struggling to breathe can be a real challenge for clinicians using conventional therapies.

However, the Foothills Medical Centre in Calgary has been delivering dramatic results using Baxter Canada’s Volara Oscillation and Lung Expansion (OLE) system, says Dr. Christina Thornton, an adult respirologist and assistant professor at the University of Calgary’s Cumming School of Medicine.

Bronchiectasis is the third most common airway disease after COPD and asthma, said Dr. Thornton. “In fact, CF, which is much better known, is actually a type of bronchiectasis. Both are characterized by shortness of breath, copious amounts of very thick mucus that is hard to clear and, over time, repeated cycles of infection, causing exacerbations or flare-ups resulting in more mucus, more coughing and more shortness of breath.”

Traditional treatments include aerobic activity for very mild cases, chest physiotherapy including manual percussion, postural drainage, and the use of a nebulizer to deliver saline or pulmozyne to break down mucus and make it easier to expel.

The Volara system is a relatively new method of treating CF and bronchiectasis patients that provides alternating cycles of continuous positive expiratory pressure (CPEP) and continuous high frequency oscillation (CHFO), along with aerosol delivery of saline or medication via an integrated nebulizer to help maximize treatment effectiveness.

The positive pressure expands and keeps the airways open, while the oscillation, a pneumatic form of chest therapy, loosens and mobilizes secretions.

“Where we have seen really good efficacy is with patients who have really thick, tenacious mucus that we are unable to clear using manual percussion,” said Dr. Thornton. “These patients tend to be frail and co-morbid without a lot of other options after traditional approaches have failed to clear their mucus.”

Dr. Thornton cites the example of one patient who was receiving extremely high levels of oxygen on a specialized Airvo high-flow system for a week. “We used the Volara and within a few days, we went from needing the maximum oxygen you can give someone to a magnitude of less oxygen.”

While the hospital has no hard data on how the Volara system affects patient length of stay, anecdotal examples indicate speedier discharge of patients in some circumstances, she said.

In the United States, where the Volara system was introduced in 2020, Baxter has data indicating a 1.6-day reduction in hospital length of stay, a two-day reduction in ICU length of stay and a 68 percent reduction in time on ventilator.*

Foothills Medical Centre received its first Volara system in 2022 and began using it primarily for CF and bronchiectasis patients in worst case scenarios, said Dr. Thornton.

“But because it was working so well, we asked ourselves, ‘Why are we only using it in these extreme cases?’ So now we’re using it on patients with mucus plugging who aren’t necessarily so sick.”

She added, “We’ve also broadened its use for other patients with thick mucus plugging who might benefit from it, including patients with lung cancer and allergic bronchial pulmonary aspergillosis.”

After acquiring two additional units, the hospital started using the Volara system post-op on thoracic patients who are in a lot of pain and therefore unable to tolerate manual percussion.
“Good mucus clearance is important for post-op thoracic patients,” noted Dr. Thornton, “because we don’t want to run into any problems that interfere with their recovery.”

Burn unit patients with skin grafts on their chest may also benefit from use of the Volara system as they, too, wouldn’t be candidates for manual percussion, she acknowledged.

Another benefit of using the Volara system is that it takes only 10 to 15 minutes to complete a treatment. That compares with 40 to 45 minutes that it would otherwise take to administer manual percussion, promoting more efficient use of hospital resources and faster relief for patients.

The device sits on a stand that can be wheeled from patient to patient and features a digital touchscreen that allows the clinician to change the pressure, time and frequency, and program presets for standardization of therapy across patient groups.

“It’s very user-friendly and patients like it, too, because they can see when the Volara is about to switch from positive pressure to oscillation and to prepare for it,” said Dr. Thornton.

The Volara system was officially introduced to Canada in 2024 but is already well known in Calgary because of its earlier acquisition by the University of Calgary’s Adult CF Clinic and Foothills Medical Centre.

“Everyone in our respiratory division at Foothills Medical Centre uses it and thinks about it when they see patients,” said Dr. Thornton. “Because of the rounds we do at the other three hospitals in Calgary, respirologists there are also aware of it, and many of them have procured the Volara system because they also want their patients to have access to it.”

Baxter is now focused on replicating Calgary’s successful adoption of the Volara system across Canada’s healthcare landscape.

Disclaimer: This interview was sponsored by Baxter Canada; however, the opinions expressed by the healthcare provider are solely her own. This represents one healthcare provider’s perspective, and individual outcomes may vary.

*Source: Reference from Volara brochure – Huynh TT, Liesching TN, Cereda M, Lei Y, Frazer MJ, Nahouraii MR, et al. Efficacy of Oscillation and Lung Expansion in Reducing Postoperative Pulmonary Complication, JACS (2019).

CA-FLC188-250006 (v2.0) 08/2025