Lung drainage, or airway clearance, involves techniques designed to help individuals clear excessive mucus and secretions from their respiratory passages. This buildup can cause congestion, making breathing difficult and potentially increasing the risk of infection. While the body has a natural clearance system, these supportive techniques use physical maneuvers and controlled breathing. They mobilize mucus from the smaller airways into the larger ones, where it can be more easily coughed up, offering temporary relief.
Postural Drainage Techniques
Postural drainage uses gravity to move secretions from the lungs’ smaller branches into the central airways. The technique involves positioning the body in various ways to elevate the lung segment needing drainage above the main bronchial tube. This approach should be performed before a meal or at least 90 minutes after eating to prevent nausea.
To drain the basal segments of the lower lungs, lie on your back or stomach with the hips elevated higher than the chest, often using pillows or a wedge. This head-down tilt encourages secretions to flow toward the trachea. For draining side segments, lie on your side, propping the hips up while the upper body remains lowered.
Maintain each position for five to fifteen minutes, allowing gravity sufficient time to act. During this time, breathe slowly and deeply, inhaling through the nose and exhaling slowly through the mouth. Afterward, perform a cough or huffing maneuver to clear the mobilized mucus from the larger airways.
Active Cycle of Breathing and Huffing
The Active Cycle of Breathing Technique (ACBT) is a self-directed airway clearance method that promotes the mobilization of mucus without causing excessive fatigue. ACBT cycles through three main phases: breathing control, thoracic expansion exercises, and huffing (forced expiration).
Breathing Control
The cycle starts with quiet, gentle, relaxed breathing using the diaphragm, allowing the abdomen to rise and fall. This phase is important for relaxing the airways and preventing an irritable cough.
Thoracic Expansion Exercises
Next, perform three to five slow, deep breaths, often holding the breath for two or three seconds at peak inhalation. These deep breaths help air get behind the mucus, expanding the lungs and encouraging secretions to loosen from the airway walls.
Huffing
Huffing is a controlled forced exhalation performed with an open mouth and throat, similar to fogging a mirror. Take a medium-sized breath in, then forcefully squeeze the air out using the stomach muscles. This maneuver creates a high expiratory airflow that shears the mucus from the airway walls and moves it upward. The cycle repeats until the lungs feel clear.
Manual and Mechanical Clearance Assistance
External forces can be applied to the chest wall to help dislodge and move thick secretions. Manual chest physiotherapy, often performed by a caregiver or therapist, includes techniques like percussion and vibration.
Manual Techniques
Percussion involves rhythmically striking the chest wall with a cupped hand over the lung segment being drained. This creates a pressure wave that helps loosen mucus adhering to the bronchial walls. The cupped hand technique should produce a hollow sound, not a painful slapping noise, and is typically performed for about five to seven minutes per area. Vibration is a manual technique where the caregiver applies a fine, rapid, oscillatory movement to the chest wall during the patient’s exhalation, aiding movement toward the central airways.
Mechanical Devices
For individuals requiring frequent or more intensive assistance, mechanical devices offer an automated alternative. Oscillating positive expiratory pressure (OPEP) devices, such as flutter valves, are handheld tools that use breathing resistance and high-frequency oscillations to thin and loosen secretions. High-frequency chest wall oscillation (HFCWO) systems use a vest that inflates and deflates rapidly, creating a mechanical percussion effect across the chest. These devices mimic the forces of manual percussion and vibration.
Supportive Home Measures
Simple home measures can significantly improve mucus consistency, making drainage easier and more comfortable. Hydration is primary; drinking plenty of fluids helps thin the mucus, reducing stickiness and facilitating movement. Warm liquids, such as herbal teas or broths, can also help loosen thickened secretions as they are consumed.
Moisturizing the air is effective, as dry air irritates the nose and throat. Using a cool mist humidifier adds moisture, keeping respiratory passages lubricated and secretions thinner. Inhaling steam from a hot shower or a bowl of warm water provides immediate, localized relief.
Saline solutions, used via nasal spray or gargling with warm salt water, help clear the upper respiratory tract. The salt water draws moisture into the airways, further aiding thinning. Additionally, positioning the head slightly elevated during rest, using extra pillows, prevents secretions from pooling uncomfortably at the back of the throat.
Recognizing When to Seek Medical Care
Home-based drainage techniques and supportive measures are helpful for temporary congestion, but it is important to recognize when symptoms signal a more serious underlying condition requiring professional medical attention. Seek care if congestion fails to improve after a week of home treatment or if a cough lasts longer than three weeks.
Immediate Emergency Symptoms
Certain symptoms constitute immediate medical emergencies and require prompt attention:
- Sudden or severe shortness of breath or difficulty breathing.
- Chest pain or pressure, particularly if it feels tight or crushing.
- Coughing up blood (hemoptysis).
- A high fever (100.4°F or higher) that persists or spikes quickly.
- A change in skin color, such as the lips or fingertips turning blue or gray, indicating severely low oxygen levels.
Individuals with pre-existing conditions like COPD or heart disease should seek prompt medical advice sooner if they experience a noticeable change in their respiratory symptoms.