The Monarch Airway Clearance System
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The Monarch® Airway Clearance System

The Monarch® System provides mobile High Frequency Chest Wall Oscillation (HFCWO) vest therapy to help thin and mobilize secretions from the airways.


This revolutionary airway clearance vest technology combines mobility with targeted kinetic energy and airflow to thin and mobilize secretions from the airways.

And it works with the Hillrom™ Connex® App and Health Portal to help patients and care teams share therapy session data and spirometry results. With this powerful connection, patients can manage their daily care routines and clinicians can create more informed care plans. The Monarch System airway clearance vest combines freedom and connection to help patients take control of their therapy—and their lives.



The Monarch® System is a HFCWO therapeutic device with revolutionary technology. This vest therapy clears the airways by combining mobility with targeted kinetic energy and airflow to thin and mobilize secretions. Because when patients can move about freely during therapy, they can take control of their therapy—and their lives.

Powered by PODs

The Monarch® System features eight pulmonary oscillating discs (PODs) containing magnets, that are anatomically placed over the upper and lower lobes of the lungs. The PODs oscillate and provide a targeted kinetic energy to the lungs. Airflow is generated to help thin and move mucus from the small airways to the large airways, where it can be coughed out or suctioned.


A rechargeable battery powers therapy on the move.


Study shows that The Monarch® System aids sputum production.1


App & portal help patients and care teams share therapy and spirometry results.

The Hillrom Connex App and Portal are shown on a smartphone and desktop computer monitor with spirometer.

Connection You Can Feel Good About

The Hillrom Connex® App and Health Portal help patients and clinicians clearly see day-to-day therapy results, so they can make better decisions together. The app also helps patients keep track of everything from medications and Pulmonary Function Tests (PFTs) to nutrition, exercise and more—rewarding healthy behaviors and empowering them to feel their best. Now using the Smart One® Spirometer, patients can also track lung health at home using the Connex App.


Meet the mind behind the Monarch® System: Marten De Vlieger

Marten De Vlieger and his sister were both born with cystic fibrosis (CF). As they grew up, their mother had to manually administer chest physiotherapy (CPT) to them, to help clear their airways. But Marten envisioned a life with more independence. He created a mobile therapeutic device to provide him with the airway clearance therapy he needed. It freed him to travel, to pursue his love of kite-surfing, to have adventures, and to raise his own family. And when Marten told us that he wanted others to experience the flexibility and control he’d claimed for himself, we gladly partnered with him to develop the Monarch® Airway Clearance System.

Man using The Monarch® Airway Clearance System

Technical Specifications

Dig deeper into product attributes to see how we can fit your requirements.

Weight 13 lbs. (with battery)
Mid-Torso Circumference Fits 22" to 50"
Base Material EVA foam
Shell Material Polyester
Battery Lithium-ion

Education & Documentation

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Product Documentation

  • Videos

  • Documents

    Icon PDP
    Leemansc Fluidda Monarch CaseStudy
    Monarch Patient Brochure
    Monarch Clinician Brochure

Frequently Asked Questions

  • How do I ensure the Monarch® System fits my patients properly?

    A licensed, professional Hillrom trainer will come to your patient's home to provide a personalized fitting and Monarch® System training. Afterward, your patient may need additional fit adjustments as the Monarch® device's foam conforms to his or her body. If you have any questions about device fit, please call Hillrom Customer Service at 800-426-4224.
  • What are the Monarch® System's maintenance requirements?

    Although the Monarch® System requires no general maintenance, its cleaning guidelines are listed in its User Manual.
  • Are the shells machine-washable and dryable?

    Yes. The vest shell can be machine-washed and tumble-dried on low heat. The shoulder pads, backpack cover, and POD covers should be wiped down with an approved cleaner. Refer to the Monarch® System's User Manual for full cleaning guidelines.
  • How does the Monarch® System provide therapy to the entire lung when the PODs are only touching the torso in eight places?

    Excellent question. The Monarch® System employs a clearance therapy known as High Frequency Chest Wall Oscillation (HFCWO) to thin and mobilize secretions from the airways and help improve respiratory health. Its Pulmonary Oscillating Discs (PODs) deliver targeted kinetic energy to both lungs' upper and lower lobes, front and back. This helps to thin mucus and increase airflow throughout the lungs. That stronger airflow can get behind secretions, lift them away from airway surfaces, and move them along from the small airways to the large airways, from which they can be more easily coughed or suctioned out.
  • How does the Monarch® System's therapy differ from that of the Vest® System?

    Both provide HFCWO therapy to clear the airways. Whereas the Vest® System uses an airbladder system to deliver airflow-generating energy over the entire chest wall, the Monarch® System uses its magnet-containing PODs deliver energy to specific regions of the lungs' upper and lower lobes, therefore wearing a Monarch® garment may feel different from wearing a Vest® garment. The Monarch® System's targeted kinetic energy likewise thins mucus and generates airflow to mobilize secretions.
  • Do health insurance companies typically cover the Monarch® System?

    Contact your (or your patient's) insurance company to determine coverage for High Frequency Chest Wall Oscillation (HFCWO) devices. The Monarch® System is intended for patients who are 15+ years old.
  • How often does Hillrom contact Monarch® patients?

    A member of the Hillrom Respiratory Health’s clinical staff will periodically call the patient to discuss how the system is working for him or her and to answer any questions. Insurance providers may request this data to ensure that the device is being used.
  • Can I travel on an airplane with the Monarch® System?

    When traveling with the Monarch® System, it's recommended that patients review the latest medical device regulations on the U.S. Transportation Security Administration's website (www.tsa.gov). The Monarch® System has a lithium-ion battery and current TSA guidelines allow a lithium-ion battery to be included only in carry-on luggage (it may not be included in checked luggage). When a bag is checked at the gate or at plane-side, the Monarch® System's battery must be removed and kept with the passenger in the aircraft cabin. The travel agent or airline should be able to answer questions regarding the requirements for traveling with medical devices. Patients might also consider carrying a letter from their physician, stating their medical condition(s) and medical need for the device.

Respiratory FAQs

Smart One® is a registered trademark of MIR S.R.L. – Medical International Research LLC.
Monarch® is a registered trademark of Hill-Rom Services PTE Ltd. Connex® is a registered trademark of Welch Allyn, Inc.

  1. Leemans G, De Hondt A, Ides K, et al. Evaluation of a mobile HFCWO device in patients with cystic fibrosis. Pediatric Pulmonology. September 2018;53(S2):S1-S481.