Table of ContentsView AllTable of ContentsMethodsBenefitsAlternatives
Table of ContentsView All
View All
Table of Contents
Methods
Benefits
Alternatives
Deep breathing, lung exercises, and tapping on the chest are a few of the techniques that fall under what’s known as pulmonary hygiene. These strategies are used in people with chronic conditions likechronic obstructive pulmonary disease (COPD),cystic fibrosis, andbronchiectasisto help remove mucus build-up from blocking the lungs.
Also Known AsPulmonary hygiene is also sometimes called bronchopulmonary hygiene, airway clearance, or pulmonary toilet.
Also Known As
Pulmonary hygiene is also sometimes called bronchopulmonary hygiene, airway clearance, or pulmonary toilet.
Lumi Images/Romulic-Stojcic / Getty Images
Pulmonary Hygiene Methods
There are several facets of pulmonary hygiene. They all entail the use of physical manipulation techniques to help you cough up sticky mucus. You and your therapist may use any combination of techniques during a pulmonary hygiene session.
Controlled Coughing
Controlled coughingis one of the most effective means of airway clearance in lung disease. Your therapist or nurse can show you the proper way to sit and how to cough to make it productive.
Deep Breathing
Deep breathing is as simple as it sounds: You breathe in deeply and then attempt to cough up mucus and secretions. A physical therapist should be able to instruct you in the most effective breathing techniques for your condition.
Breathing Exercises That Help with Lung Disease
Incentive Spirometry
An incentive spirometer is a medical device that you can use to exercise your lungs. As you breathe in slowly and deeply, it measures how much air you are breathing in. This measurement can be used as a benchmark for you to exercise your lungs.
How to Use an Incentive Spirometer
Chest Percussion
If you will havechest percussion, your therapist will tap on your chest repeatedly or do so with a mechanical device. The resulting vibration may help break up thick mucus that is trapped in your lungs so that you can expel it more easily.
Chest Vest
Chest vests, also called high-frequency chest wall oscillation (HFCWO) devices, are worn to help loosen mucus and clear the airway. The vest vibrates and is either plugged in or run on a battery. Coughing is done throughout the session and afterward to expel mucus.
Postural Drainage
This method uses your body’s position (with assistance from gravity) to help drain the mucus out of your lungs. Your physical therapist or respiratory therapist will tell you exactly how to position yourself for this procedure. Postural drainage is often performed along with chest percussion, which breaks up mucus in the lungs.
How Postural Drainage Is Done
While this type of therapy has been used for many years, experts have not been able to definitively verify its long-term benefits. Pulmonary hygiene is believed to help preventatelectasis, a harmful effect oflung diseasein which thealveoli(tiny air sacs in your lungs) collapse, making it difficult to breathe.
If you’ve been hospitalized with COPD, it’s possible that pulmonary hygiene can help lessen your need for a mechanical respirator, and it may also reduce the length of your hospital stay. However, it doesn’t appear to reduce the number ofCOPD exacerbations, nor does it reduce the number of COPD-related hospitalizations.
Pulmonary hygiene is only one of several ways of preventing atelectasis.Other physical methods and prescription medicationscan help as well.
You can also use pulmonary hygiene techniques along with other methods of clearing your lungs.
Alternatives to Pulmonary Hygiene
Pulmonary hygiene techniques are considered safe, and many people who have lung disease feel a sense of improvement with this therapeutic approach. Yet, you may feel that pulmonary hygiene is inadequate for managing your symptoms, or you might find it inconvenient or physically uncomfortable.
In addition to or instead of pulmonary hygiene, there are other methods that can be used to decrease or thin your respiratory mucus. Speak to your healthcare provider about:
A Word From Verywell
It can be difficult to predict whether this approach will be right for you unless you try it. Overall, the most effective management of respiratory disease includes a wide range of approaches—ranging from medications to lifestyle changes.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jelic S, Cunningham JA, Factor P.Clinical review: airway hygiene in the intensive care unit.Crit Care. 2008;12(2):209. doi:10.1186/cc6830Kumara P, Yimam W, B A, Getachew Y, A S.Practice on pulmonary hygiene and associated factors among health professionals working in two government hospitals at Amhara, Ethiopia.International Journal of Medical and Health Research. 2017;3(10):40-43.Leemans G, Belmans D, Van Holsbeke C, et al.The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearance.Pediatr Pulmonol. 2020;55(8):1984-1992. doi:10.1002/ppul.24784Aaron SD.Mucolytics for COPD: negotiating a slippery slope towards proof of efficacy.Eur Respir J. 2017;50(4). doi:10.1183/13993003.01465-2017Additional ReadingLee AL, Burge AT, Holland AE.Airway clearance techniques for bronchiectasis. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online November 23, 2015. doi:10.1002/14651858.CD008351.pub3Leelarungrayub J, Eungpinichpong W, Klaphajone J, Prasannarong M, Boontha K.Effects of manual percussion during postural drainage on lung volumes and metabolic status in healthy subjects.J Bodyw Mov Ther. 2016 Apr;20(2):356-63. doi:10.1016/j.jbmt.2015.11.002Osadnik, C., McDonald, C., Jones, A., and A. Holland.Airway clearance techniques for chronic obstructive pulmonary disease.Cochrane Database of Systematic Reviews. 2012. (3):CD008328.Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T.Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online December 8, 2016. doi:10.1002/14651858.CD005305.pub4Spapen HD, De Regt J, Honoré PM.Chest physiotherapy in mechanically ventilated patients without pneumonia—a narrative review.J Thorac Dis. 2017;9(1):E44-E49. doi:10.21037/jtd.2017.01.32
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jelic S, Cunningham JA, Factor P.Clinical review: airway hygiene in the intensive care unit.Crit Care. 2008;12(2):209. doi:10.1186/cc6830Kumara P, Yimam W, B A, Getachew Y, A S.Practice on pulmonary hygiene and associated factors among health professionals working in two government hospitals at Amhara, Ethiopia.International Journal of Medical and Health Research. 2017;3(10):40-43.Leemans G, Belmans D, Van Holsbeke C, et al.The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearance.Pediatr Pulmonol. 2020;55(8):1984-1992. doi:10.1002/ppul.24784Aaron SD.Mucolytics for COPD: negotiating a slippery slope towards proof of efficacy.Eur Respir J. 2017;50(4). doi:10.1183/13993003.01465-2017Additional ReadingLee AL, Burge AT, Holland AE.Airway clearance techniques for bronchiectasis. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online November 23, 2015. doi:10.1002/14651858.CD008351.pub3Leelarungrayub J, Eungpinichpong W, Klaphajone J, Prasannarong M, Boontha K.Effects of manual percussion during postural drainage on lung volumes and metabolic status in healthy subjects.J Bodyw Mov Ther. 2016 Apr;20(2):356-63. doi:10.1016/j.jbmt.2015.11.002Osadnik, C., McDonald, C., Jones, A., and A. Holland.Airway clearance techniques for chronic obstructive pulmonary disease.Cochrane Database of Systematic Reviews. 2012. (3):CD008328.Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T.Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online December 8, 2016. doi:10.1002/14651858.CD005305.pub4Spapen HD, De Regt J, Honoré PM.Chest physiotherapy in mechanically ventilated patients without pneumonia—a narrative review.J Thorac Dis. 2017;9(1):E44-E49. doi:10.21037/jtd.2017.01.32
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Jelic S, Cunningham JA, Factor P.Clinical review: airway hygiene in the intensive care unit.Crit Care. 2008;12(2):209. doi:10.1186/cc6830Kumara P, Yimam W, B A, Getachew Y, A S.Practice on pulmonary hygiene and associated factors among health professionals working in two government hospitals at Amhara, Ethiopia.International Journal of Medical and Health Research. 2017;3(10):40-43.Leemans G, Belmans D, Van Holsbeke C, et al.The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearance.Pediatr Pulmonol. 2020;55(8):1984-1992. doi:10.1002/ppul.24784Aaron SD.Mucolytics for COPD: negotiating a slippery slope towards proof of efficacy.Eur Respir J. 2017;50(4). doi:10.1183/13993003.01465-2017
Jelic S, Cunningham JA, Factor P.Clinical review: airway hygiene in the intensive care unit.Crit Care. 2008;12(2):209. doi:10.1186/cc6830
Kumara P, Yimam W, B A, Getachew Y, A S.Practice on pulmonary hygiene and associated factors among health professionals working in two government hospitals at Amhara, Ethiopia.International Journal of Medical and Health Research. 2017;3(10):40-43.
Leemans G, Belmans D, Van Holsbeke C, et al.The effectiveness of a mobile high-frequency chest wall oscillation (HFCWO) device for airway clearance.Pediatr Pulmonol. 2020;55(8):1984-1992. doi:10.1002/ppul.24784
Aaron SD.Mucolytics for COPD: negotiating a slippery slope towards proof of efficacy.Eur Respir J. 2017;50(4). doi:10.1183/13993003.01465-2017
Lee AL, Burge AT, Holland AE.Airway clearance techniques for bronchiectasis. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online November 23, 2015. doi:10.1002/14651858.CD008351.pub3Leelarungrayub J, Eungpinichpong W, Klaphajone J, Prasannarong M, Boontha K.Effects of manual percussion during postural drainage on lung volumes and metabolic status in healthy subjects.J Bodyw Mov Ther. 2016 Apr;20(2):356-63. doi:10.1016/j.jbmt.2015.11.002Osadnik, C., McDonald, C., Jones, A., and A. Holland.Airway clearance techniques for chronic obstructive pulmonary disease.Cochrane Database of Systematic Reviews. 2012. (3):CD008328.Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T.Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online December 8, 2016. doi:10.1002/14651858.CD005305.pub4Spapen HD, De Regt J, Honoré PM.Chest physiotherapy in mechanically ventilated patients without pneumonia—a narrative review.J Thorac Dis. 2017;9(1):E44-E49. doi:10.21037/jtd.2017.01.32
Lee AL, Burge AT, Holland AE.Airway clearance techniques for bronchiectasis. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online November 23, 2015. doi:10.1002/14651858.CD008351.pub3
Leelarungrayub J, Eungpinichpong W, Klaphajone J, Prasannarong M, Boontha K.Effects of manual percussion during postural drainage on lung volumes and metabolic status in healthy subjects.J Bodyw Mov Ther. 2016 Apr;20(2):356-63. doi:10.1016/j.jbmt.2015.11.002
Osadnik, C., McDonald, C., Jones, A., and A. Holland.Airway clearance techniques for chronic obstructive pulmonary disease.Cochrane Database of Systematic Reviews. 2012. (3):CD008328.
Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T.Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Airways Group, ed.Cochrane Database of Systematic Reviews. Published online December 8, 2016. doi:10.1002/14651858.CD005305.pub4
Spapen HD, De Regt J, Honoré PM.Chest physiotherapy in mechanically ventilated patients without pneumonia—a narrative review.J Thorac Dis. 2017;9(1):E44-E49. doi:10.21037/jtd.2017.01.32
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