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Table 7: Airway cleaning /bronchial hygiene. |
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|
Technique |
Advantages |
Comment / disadvantage |
|
Directed cough |
Cheap, simple |
Chest pain may limit |
|
Regular exercise |
Economical, strengthens respiratory and peripheral muscles |
|
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Autogenous breathing |
Control your breathing |
Requires patient cooperation |
|
Forced expiration |
Helps control breathing |
Requires patient learning |
|
Thoracic physiotherapy (CPT; postural drainage, mechanical or manual thoracic percussions) |
Most tested in cystic fibrosis |
Needs assistant, difficult to place, hypoxemia, sometimes worsens gastroesophageal reflux |
|
Positive expiratory pressure (PEP) |
Easy, cheap |
Device needs cleaning |
|
Oscillatory PEP (e.g., acapella device with flutter valve) |
Easy, economical, adds vibration to the airways |
Device needs cleaning |
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High frequency chest wall oscillation vest with inflatable bladder |
Extensive experience |
Pain may limit; needs power outlet |
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High frequency chest wall oscillation vest with mechanical oscillators |
Doesn’t hurt compared to inflatable bladder |
May be mobile; small batteries in vest; closest to CPT |
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CPT = chest physical therapy. |
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