3 Basic Techniques to Clear Mucus From the Lungs

Ways to Unblock Air Passages If You Have COPD

One of the hallmark symptoms of chronic obstructive pulmonary disease (COPD) is the excessive production of mucus. Not only can these secretions block already-narrowed air passages, they can become a breeding ground for infections such as ​bacterial pneumonia.

There are techniques that can help prevent this. When performed correctly, they can be just as important a facet of COPD treatment as bronchodilators and steroid medications.

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man cough COPD
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Controlled coughing is a therapeutic technique that engages both the chest and stomach muscles in a way that improves mucus clearance.

Unlike hacking which uses the chest muscles more than the diaphragm, controlled coughing focuses on stabilizing the core muscles to engage the diaphragm more effectively.

There are two techniques you can use:

  • Deep coughing is especially useful for people who have difficulty mustering a strong, productive cough. With this technique, you would site comfortably in a chair with your feet on the ground. Wrapping your arms around your stomach, you would inhale deeply and emit a forceful cough while compressing your arms firmly against your stomach muscles. By keeping your lips pursed rather than loose, you force the diaphragm to do more of the work.
  • Huff coughing involves taking a deep, slow breath to fully fill the lungs. Then, tensing your stomach muscles, you would make three rapid exhalations with your mouth open, making a "ha" sound with each exiting breath. Continue repeating this, keeping your core firm, until you feel the mucus breaking up. You can then take a deep cough to clear your lungs.

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Acapella Flutter Vibratory PEP Therapy
Acapella Flutter Vibratory PEP Therapy. Image courtesy Smiths Medical (UK)

Chest physiotherapy (CPT) is a clearance technique performed either manually with a partner or alone with a mechanical device.

  • Manual CPT combines percussion (in which cupped hands are repeatedly clapped against the chest or back) and vibration (in which flat hands vibrate the chest wall) to loosen the mucus and induce a cough. The technique can be performed in several positions to allow gravity to do some of the work. Your role as the recipient is to inhale and exhale slowly and fully until the mucus in loose enough to be expelled.
  • Airway clearance devices are hand-held machines that use high-frequency vibration, low-frequency sound waves, and other techniques to break up mucus. They are relatively inexpensive, easy to use, and allow a person to clear mucus without the need of a partner. Some of the devices are worn like a vest, while others require you to breathe into them like a flute.

Both clearance techniques are commonly performed on a routine basis to keep the air passages unobstructed. Depending on the severity of the COPD symptoms, the routine can take anywhere from 20 minutes to an hour to perform.

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Cough Syrup Bottle
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An expectorant is a type of oral medication that helps break up mucus so that it can be easily coughed up. It does so by stimulating the vagus nerve in the stomach, which increases airway secretions and reduces the viscosity of the mucus.

Expectorants can also block the production of mucins, the main protein found in mucus.

While over-the-counter expectorants like Robitussin or Mucinex are commonly used by people with COPD, they are not officially endorsed in the guidelines issued by the Global Initiative for Obstructive Lung Disease (GOLD). Current research remains divided on whether the drugs can improve lung function or long-term outcomes in people living with the disease.

Despite this, doctors will readily prescribe expectorants as they are unlikely to do any harm and may help ease acute COPD exacerbations.

Sources:

Ides, K.; Vissers, D.; De Backer, L et al. "Airway clearance in COPD: Need for a breath of fresh air? A systematic review." COPD. 2011; 8(3):196-205. DOI: 10.3109/15412555.2011.560582.

Zhang, T. and Zhou. X. "Clinical application of expectorant therapy in chronic inflammatory airway disease." Exp Ther Med. 2014; 7(4):763-67. DOI: 10.3892/etm.2014.1494.

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