Airway Clearance Center
Why Carry Out Mucus Clearance Therapy
Mucus Clearance Therapy has been a mainstay of the treatment of cystic fibrosis and the treatment of some other pulmonary problems for many, many years. Mucus clearance therapy is prescribed for patients with cystic fibrosis at CF Centers throughout the world. This therapy takes time and one might reasonably ask " Why should I do it? " The answer is: If mucus therapy is not carried out it is worse for your lungs in the long run. We say this for the following reasons:
There have been several studies of chest physiotherapy (the most common form of mucus clearance therapy). In a group of patients receiving therapy, the therapy was stopped, pulmonary function dropped and weeks later when the therapy was restarted, pulmonary function rose again. This evidence indicates to us that chest physiotherapy does loosen and clear mucus from the lungs and thereby improves lung function. If the lungs have less infected mucus present, there should be less ongoing and permanent damage to the lungs thereby preserving lung function over the long term. Some might ask the question, " Last summer I went on vacation and did not do therapy and did not feel any worse, so why should I do therapy now? " Patients who produce lots of mucus often feel worse if they miss therapy. Patients with little mucus production usually do not feel worse. However, there is inflammation and extra mucus in the lungs of very healthy patients. As a physician, my philosophy is to do everything possible to keep people1s lungs healthy so (1) they are healthy in the long run and (2) so their lungs have as little scarring as possible in the long run. Therefore, my patients1 will be better able to benefit from the newer CF therapies currently being studied.
There are several approaches to chest physiotherapy. Chest physiotherapy with positioning, percussion (clapping), vibration and coughing is the standard technique. Over the last 5-10 years more and more centers have used the PEP valve and more recently the FLUTTER device. PEP therapy has been extensively tested and is equivalent to standard chest physiotherapy. The FLUTTER device has been less extensively tested but research so far indicates that the FLUTTER valve is as effective or possibly more effective clearing mucus when compared with standard chest physiotherapy. Autogenic drainage is a technique more widely used in Europe than in the United States. This technique involves coughing at different lung volumes and can be taught and successfully carried out by older cooperative patients. Vigorous exercise is also very helpful in clearing mucus. If you would like to substitute exercise for some of your therapies, speak with your physician to see if this is advisable. Speak with your CF Center physician, nurse or respiratory therapist if you would like more information about specific therapy approaches which may work well for you.