Airway Clearance Devices for Pulmonary Disease

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There are a number of devices that you can use to help clear excess sputum (the combination of mucus and saliva) from your airways. Many respiratory diseases, such as cystic fibrosis and chronic obstructive pulmonary disease (COPD) are characterized by sputum and mucus build-up in the lungs.

Your medical team can help you select the device that is right for you and can also show you how to use it properly. You can breathe as you normally do while using some of the devices, while others require your active participation.

Benefits of Airway Clearance Devices

Accumulation of mucus and sputum restricts air from freely flowing into and out of the lungs. This contributes to wheezing, coughing, and shortness of breath in obstructive lung diseases, such as chronic bronchitis and emphysema.

Clearing this accumulation provides substantial relief of symptoms, increasing your ability to comfortably take a deep breath. Airway clearance devices can also help prevent complications of respiratory diseases, such as lung infections.

You can use an airway clearance device along with your other treatments, including medications and airway clearance techniques.

Incentive Spirometry

A spirometer, which measures the volume of air that you exhale (breath out) and inhale (breath in), can be used as a diagnostic test and as a therapeutic tool. When you use a spirometer, you may be instructed to control the rate of each breath, in addition to exhaling a certain target volume of air.

Using an incentive spirometer can help prevent the build-up of sputum in your lungs because it encourages you to exhale as much as possible.

Intrapulmonary Percussive Ventilation (IPV) Device

An IPV device delivers small bursts of air into your lungs through a mouthpiece. You can continue to inhale and exhale as you normally would while you are using an IPV device.

The pulsatile bursts of air delivered with an IPV device serve to vibrate the chest, which loosens mucus deep in the airways.

Oral High-Frequency Oscillation (OHFO) Device

These devices deliver low volume, high-frequency jet oscillation to your lungs through a mouthpiece. The oscillation is produced by the use of sound frequency. You can inhale and exhale as usual while using this device.

Using this device helps clear carbon dioxide and sputum from your lungs.

Positive Expiratory Pressure (PEP) Therapy

With positive expiratory pressure (PEP) therapy, you use a face mask or a mouthpiece while inhaling and exhaling as you normally would. A mechanical device provides mild air pressure as you exhale.

This process allows more air to enter into the small airways in your lungs, creating pressure to gently dislodge excess sputum. The sputum is pushed toward the larger airways, making it easier to cough up.

Some of the more popular devices are marketed under the names Astra PEP, Pari PEP, and AeroPEP.

Flutter Mucus Clearance System

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Combining PEP therapy with high-frequency oscillation, the Flutter Mucus Clearance Device is a controlled vibration system that gently oscillates the large and small airways in the lungs. Oscillating devices like this create vibrations when you exhale.

This action helps loosen mucus from bronchial walls while accelerating airflow to better stimulate mucus clearance. After blowing through the device several times, you can usually cough out the accumulated mucus.

If you have severe airway obstruction, you may not be able to generate enough airflow to allow a Flutter Mucus Clearing device to work properly.

Similar devices are marketed under names Acapella, Cornet, and Aerobika OPEP.

High-Frequency Chest Wall Oscillation (HFCWO)

High-frequency chest wall oscillation (HFCWO) is comprised of an inflatable vest which uses air pressure to gently vibrate the chest wall. This action increases airflow to the smaller passages and aids in the clearance of mucus.

You can use the vest for five minutes at a time and then cough and huff to clear the loosened mucus. Sessions last for around 20 to 30 minutes.

Examples of the HFCWO device include the Vest Airway Clearance System and the Medpulse Respiratory Vest System.

Lung Flute Acoustic Induction Device

The Lung Flute is a hand-held device that generates low-frequency sound waves into the airways as you vigorously exhale through a reeded mouthpiece (similar to blowing into a clarinet). The waves travel down into the lower airways and stimulate mucus clearance.

In order to achieve the best results, you would blow into the Lung Flute for up to 20 sets of two blows per set.

Airway Clearance Techniques

Airway clearance devices are generally used in conjunction with airway clearance techniques (ACT) and medication. To better facilitate clearance, a bronchodilator inhaler is typically used to widen airway passages while an inhaled mucolytic is used to thin mucus.

ACTs are methods used to remove sputum from your lungs. ACTs include the Huff cough technique, controlled coughing, chest percussion, and postural drainage. These techniques typically utilize physical approaches, such as having someone tap on your chest as you cough or control your breathing pattern.

A Word From Verywell

Choosing the right air clearance device is ultimately an individual choice. Each has different mechanisms of action, which some people like and others don't. When starting any ACT therapy, you need to begin slowly and build up the number of repetitions over time.

Don't hesitate to ask your doctor or respiratory therapist for advice. You may also benefit from speaking with people who have used these devices to hear their experiences.

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