Airway Clearance Devices for Managing Lung Disease

There are a number of airway clearance devices that you can use to help clear up excess sputum (the combination of mucus and saliva). They take several different forms (a mouthpiece, a mask, a vest, etc.) and use air pressure, oscillation, or high-frequency sound waves to get the job done. You may already be well familiar with some of their names: an incentive spirometer or a lung flute, for example, though there are others.

Many respiratory diseases, such as cystic fibrosis and chronic obstructive pulmonary disease (COPD), are characterized by sputum and mucus build-up in the lungs. If you have such a concern, you might use one particular airway clearance device or switch to another over the course of your disease progression.

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.

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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.

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.

How to Use an Incentive Spirometer

Intrapulmonary Percussive Ventilation (IPV) Device

An IPV device delivers small bursts of air into your lungs through a mouthpiece. These serve to vibrate the chest, which loosens mucus deep in the airways.

You can continue to inhale and exhale as you normally would while you are using an IPV device.

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 and it helps clear carbon dioxide and sputum from your lungs.

You can inhale and exhale as usual while using this device as well.

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

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 the names Acapella, Cornet, and Aerobika OPEP.

High-Frequency Chest Wall Oscillation (HFCWO)

High-frequency chest wall oscillation (HFCWO) is comprised of an inflatable vest that 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 total.

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 in 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, perform a set of two blows into the mouthpiece and repeat up to 20 times.

Complementary Therapies

For maximum benefit, these devices are generally used in conjunction with airway clearance techniques (e.g., the Huff cough technique, controlled coughing, chest percussion, or postural drainage) and medication (i.e., a bronchodilator inhaler to widen airway passages; an inhaled mucolytic to thin mucus).

A Word From Verywell

Choosing the right air clearance device is ultimately individual. Each has different mechanisms of action, which some people like and others don't. You may need time to get used to the one you select. Don't hesitate to ask your healthcare provider 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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