Lexicon of airway clearance and breathing techniques
Airway clearance techniques | |
Active cycle of breathing [10, 11] | A cycle of deep breathing exercises interspersed with breathing control, followed by the FET (a combination of 1 or 2 huffs# interspersed with periods of breathing control) |
Autogenic drainage [10, 11] | Composed of three phases: |
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Positive expiratory pressure therapy [10, 11] | Provides a constant pressure to the airways throughout expiration using an expiratory resistance device with a one-way valve |
ELTGOL (total slow expiration with open glottis) [12] | The patient lies in a lateral decubitus position and breathes out slowly through an open glottis from FRC to residual volume |
Manually assisted cough [13, 14] | Thoracic or abdominal compression added to augment the expiratory effort of a cough |
Mechanical insufflation-exsufflation [13, 14] | A device gradually inflates the lungs using positive pressure, immediately follows an abrupt change to negative pressure that produces a rapid exhalation |
Breathing strategies | |
Incentive spirometry [10] | Use of a handheld device that provides patients with visual feedback regarding their performance during deep breathing exercises; it can be provided by flow- or volume-based spirometers |
Deep breathing exercises [10] | Full inspiration to TLC, with or without a 2–3 s hold at the end of inspiration, followed by relaxed expiration |
Adequate expiratory time is required to allow complete expiration | |
Compared to a rapid inspiration, a slow inspiration allows a more homogeneous distribution of ventilation | |
Positive pressure [10] | Applying positive pressure throughout inspiration to the airways and lungs by asking the patients to breathe using a device that attaches to them via a face mask or a mouthpiece |
FET: forced expiratory technique; FRC: functional residual capacity; TLC: total lung capacity. #: a huff is described as a deep inspiration followed by a forced expiration with the glottis open.