Cough cough cough…….. I have taken various expectorants, is there any non-drug method to assist in sputum clearance?
Of course, in addition to the active breathing cycle technique introduced last time, sputum can also be “autogenously drained”.
Autogenic drainage (AD) is a airway clearance technique that utilizes different lung volumes for breathing to facilitate the expulsion of secretions from the airways. At low lung volume, this technique helps loosen more peripheral secretions; at tidal volume, secretions are collected in the central airways; and at high lung volume, the expiratory airflow reaches its maximum, aiding in the expulsion of secretions from the central airways or through coughing. The goal of this technique is to increase the expiratory flow rate, thereby more effectively clearing secretions from the airways. Below, we will introduce the operational techniques for autogenic drainage:
Belgian Method
Before starting, the patient should take a comfortable sitting or supine position. Chevaillier divides autogenic drainage into three stages.
1. “Loosening”: The patient adopts a low-volume breathing technique believed to remove peripheral mucus.
2. “Collecting”: The patient adopts a breathing method close to tidal volume to “collect” mucus from the central airways.
3. “Expelling”: The patient adopts a high lung volume breathing technique, which facilitates the expulsion of secretions from the central airways.
Finally, when enough mucus has accumulated in the large airways, it can be cleared through coughing or huffing.
As shown in the figure:
German Method
The German autogenic drainage operational steps have been re-optimized (David 1991, Kieselmann 1995), evolving into a modified version of autogenic drainage (M AD). Because the low lung volume breathing method caused discomfort for some patients, this technique no longer emphasizes the three stages; patients can adopt tidal volume breathing, holding their breath for 2-3 seconds at the end of inhalation, and then cough to expel secretions.
As shown in the figure:
Precautions:
1. Breathe slowly, keeping the upper airway (mouth and glottis) open.
2. During breathing, hold the breath for 2-3 seconds after inhalation to help gas fill the lung segments more evenly.
3. When the patient’s airways have pressure-dependent collapse, the airflow during natural breathing is greater than during forced breathing. Therefore, during exhalation, keep the upper airway open; the operation is similar to sighing, with a smooth exhalation force to achieve the highest possible exhalation flow rate without causing airway compression.
4. Avoid multiple coughs before the secretions are moved to the large airways.
In summary, autogenic drainage is a simple and effective sputum clearance technique, but correct operation and individualized guidance are key. By understanding and mastering the steps and precautions of autogenic drainage, patients and families can better manage airway secretions and improve their quality of life. It is also recommended to regularly communicate with healthcare professionals to adjust drainage strategies based on the patient’s specific situation.
Click the image link below
Make an appointment, online consultation, online follow-up
One-click access
