The Importance of Airway Clearance in Managing Lung Disease
Living with lung diseases like Chronic Obstructive Pulmonary Disease (COPD), cystic fibrosis or bronchiectasis can significantly impact daily life. One of the key factors in managing these conditions and improving quality of life is effective airway clearance(1).
What is airway clearance?
Airway clearance refers to methods and techniques used to help remove mucus and other secretions from the lungs and airways. In people with healthy lungs there are special cells, called cilia, to help keep the airways clear, but for people living with lung diseases, mucus build-up is a common problem. This build-up can lead to blocked airways, difficulty breathing, and increased risk of infections. Airway clearance techniques help to remove this mucus, promoting easier breathing.
Why is airway clearance important for those with lung disease?
- Preventing Respiratory Infections
Lung diseases like COPD, cystic fibrosis, and bronchiectasis are often characterised by the overproduction of mucus, which can become a breeding ground for harmful bacteria and viruses. When mucus accumulates in the airways, it increases the likelihood of infections such as pneumonia or bronchitis. These infections can cause exacerbations (flare-ups) of symptoms, which are difficult to recover from and can cause lung damage.
Regular airway clearance helps reduce mucus build-up. By regularly clearing the mucus, patients can keep their lungs as clear as possible, preventing infections before they start.
- Reducing the frequency of exacerbations
Lung diseases are often marked by periods of exacerbations (sudden worsening of symptoms) such as coughing, wheezing, or increased shortness of breath. These flare-ups are typically triggered by infections, environmental factors, or the build-up of mucus in the lungs.
By regularly clearing the airways, people can reduce the build-up of mucus, which lowers the likelihood of experiencing frequent flare-ups, and leads to better long-term management of their condition.
- Improving quality of life
The symptoms of lung disease, such as chronic cough, shortness of breath, wheezing, and fatigue, can greatly affect a person’s day-to-day life. These symptoms can make even the simplest activities — walking, climbing stairs, or even talking — feel challenging.
When the airways are clear, the lungs work more efficiently, allowing for better oxygen delivery to the bloodstream. This means that the body’s cells and tissues get the oxygen they need to perform essential functions.
Airway clearance techniques can improve symptoms by making breathing easier and reducing mucus build-up. This improvement in overall well-being allows people to be more physically active, feel more energetic, and maintain a better quality of life.
Common airway clearance techniques
There are several ways to clear mucus from the airways, depending on the severity of the condition and the individual’s specific needs. Here are some common techniques:
Chest physiotherapy:
This involves a series of manual techniques such as percussion (clapping) and postural drainage. A physiotherapist may use these methods to help loosen mucus and move it upwards where it can be coughed out. This method can be especially helpful for those with chronic lung diseases like cystic fibrosis or bronchiectasis.
Positive Expiratory Pressure (PEP) therapy:
PEP devices are designed to help patients clear mucus by creating positive pressure as they breathe out. The patient exhales through the device, which helps to open the airways, allowing mucus to move out more easily. Oscillating PEP devices use vibrations and air resistance to help release the mucus from the lung walls. On breathing out through the device, the air and airways start to vibrate gently, helping to move the mucus. PEP devices are a portable, easy-to-use option for many patients.
Inhalation therapy (nebulisers and inhalers):
Medications such as bronchodilators, steroids, or mucolytics (medications that thin mucus) can help open up the airways and make mucus easier to clear. These are often administered via inhalers or nebulisers, which are devices that turn liquid medications into a mist that can be breathed in.
Hypertonic saline is also a natural remedy that can help with mucus clearing. It works by thinning the mucus and making it easier to cough up. It is given through a nebuliser only. Ask your healthcare professional if this could be an option for you.
Exercise and physical activity:
Although not specifically a “clearance technique,” exercise is essential in maintaining good lung health. Simple aerobic activities like walking or cycling can help improve lung function, strengthen respiratory muscles, and promote better mucus clearance. Ask your healthcare professional if a Pulmonary Rehabilitation (PR) class is available in your area and if it would be appropriate for your condition.
To conclude, airway clearance can play a vital role in improving quality of life and slowing disease progression for anyone with lung disease.
If airway clearance is right for you, your healthcare professional can help choose the right techniques and devices for your specific needs.
(1) Belli S, Prince I, Savio G, Paracchini E, Cattaneo D, Bianchi M, Masocco F, Bellanti MT, Balbi B. Airway Clearance Techniques: The Right Choice for the Right Patient. Front Med (Lausanne). 2021 Feb 4;8:544826. doi: 10.3389/fmed.2021.544826. PMID: 33634144; PMCID: PMC7902008.
