Airway clearance not only plays an important role in the treatment of chronic sputum producing diseases such as CF or bronchiectasis, it’s also important in those who are prone to or suffer from recurrent chest infections or are recovering from surgery that means they’re less mobile.
Airway clearance
The build up of sputum can become a breeding ground for bacteria. Mucus build up that begins to obstruct the airways and an excessive cough have been associated with a number of complications. In some conditions repetitive bouts of infection can lead to worsening lung scarring and deterioration. Lots of sputum on your chest can also make you breathless as it decreases the surface area available for gas exchange. Coughing alone is not enough to move secretions from the smaller airways, and this is where the support and guidance of a respiratory physiotherapist is vital.
Airway clearance won’t just help prevent infections and prevent further scarring but it can help you feel better too.
How does airway clearance work?
There are lots of different methods involved in airway clearance, and our advice is to see a respiratory physiotherapist who will work out which is best for you.
Sputum movement will ultimately depend on several factors which will form part of the assessment by your respiratory physiotherapist. These factors include:
  • is the sputum thin or loose enough for it to move effectively?
  • can we generate enough airflow to different parts of the lungs to help move it?
  • can the we generate enough expiratory airflow (the force of the breath out) to effectively move the sputum to the larger airways?
  • is the cough strong enough?
Depending on these factors, physios may choose to introduce a breathing technique, they may want to add in a breathing device, or they may need to think about ways to make your phlegm looser – for example a nebuliser.
Other factors to be aware of

Remember that hydration plays an important factor is keeping sputum loose. Not only is drinking water beneficial for your overall health but it also helps to keep mucus thinner and make airway clearance easier. Try to drink as much water as you can on a daily basis. Aim for the standard guidelines of 2-3 litres a day. Younger children will need less than this, around 1 –1,7 litres a day. Remember that caffeinated drinks and alcohol do not count.

Exercise is also a brilliant form of airway clearance. As well as having beneficial effects on fitness levels, muscles, bone structure and posture, it also complements airway clearance and helps to keep the chest clear. We think this is normally because of the impact of feet on ground (trampolining is even better!) and changes in airflow within the lungs when we exercise.

How often is airway clearance necessary?
This is very much down to each individual as there is no “one size fits all”.

This is very much down to each individual as there is no “one size fits all”.

It can vary from one session a day to multiple times each day, especially if there is an active infection. How long each session will last is also dependent on the amount of secretions at the time. 10-15 minutes may be all that’s required if there are small amounts of secretions but longer sessions will be needed if large amounts of sputum is present.