Pulmonary Hygiene for COPD: What Are the Benefits?

Pulmonary hygiene (formerly called pulmonary toilet) may provide short-term help

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Pulmonary hygiene is a technique designed to help clear mucus and secretions from your lungs. It can be used for people who have chronic obstructive pulmonary disease (COPD), pneumonia and cystic fibrosis.

The technique, usually performed by physical therapists or respiratory therapists, uses a combination of deep breathing, lung exercises, different positions and vibration to help break up and remove the mucus.

Pulmonary hygiene, which formerly was called "pulmonary toilet," may help to prevent what's called atelectasis, which is when the tiny air sacs in your lungs collapse.

However, studies indicate that benefits of pulmonary hygiene in people who have COPD may be small, and other methods to help clear mucus — methods that don't involve a caregiver's help — may be just as effective as pulmonary hygiene. Medications also can help to clear mucus.

Pulmonary Hygiene Basics

Here's a rundown of the various methods that may be used to clear mucus during pulmonary hygiene:

  • Deep breathing. This is as simple as it sounds — you breathe in deeply and then attempt to cough up mucus and secretions. A physical therapist should be able to instruct you in the most effective breathing techniques for someone with COPD or another medical condition involving the lungs.
  • Incentive spirometry. Incentive spirometry involves a medical device that helps you to exercise your lungs. When you blow into an incentive spirometer, you also exercise your lungs, which can help to keep them clearer.
  • Postural drainage. Simply put, postural drainage uses your posture — your body's position, with an assist from gravity — to help drain mucus out of your lungs. Your physical therapist or respiratory therapist will tell you exactly how to position yourself for this. It's often used together with devices that create vibration to break up mucus.

During a pulmonary hygiene session, you and your therapist may use any combination of these techniques.

How Well Does Pulmonary Hygiene Work?

That's not clear. There have been various studies conducted on pulmonary hygiene and on the individual techniques and procedures involved, and while pulmonary hygiene does appear to be safe, the available evidence indicates only a small benefit in people with COPD. Some of the techniques are uncomfortable for the patient, too.

If you've been hospitalized with COPD, it's possible that pulmonary hygiene can help you to lessen the need for a mechanical respirator, and it may also reduce the length of your hospital stay. However, it doesn't appear to reduce the number of COPD exacerbations, nor does it reduce the number of COPD-related hospitalizations.


Jones A et al. Bronchopulmonary hygiene physical therapy in bronchiectasis and chronic obstructive pulmonary disease: a systematic review. Heart & Lung: The Journal of Critical Care. 2000 Mar-Apr;29(2):125-35.

McCool FD et al. Nonpharmacologic Airway Clearance Therapies: ACCP Evidence-Based Clinical Practice Guidelines. Chest. 2006;129;250-259.

Osadnick CR et al. Airway clearance techniques for chronic obstructive pulmonary disease. The Cochrane Database of Systematic Reviews. 2012 Mar 14;3:CD008328.

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