Airway Clearance - Not One-Size-Fits-All

Wouldn’t it be wonderful if there were only one way to do airway clearance? The truth is, there isn’t—and that’s okay. In fact, airway clearance is highly individualized, and as much an art as a science.


At every professional bronchiectasis conference I’ve attended, the message about airway clearance has been consistent: it should be taught by a respiratory professional and tailored to each person.Unfortunately, many people don’t have access to specialized education. While progress is being made, we’re not there yet.


In the meantime, peer education and webinars have become invaluable resources. A frequent topic in these discussions is the use of devices like the Ombra compressor with AeroEclipse nebulizer cups.


One advantage of this system is that the nebulizer cup can connect directly to an Aerobika OPEP (Oscillating Positive Expiratory Pressure) device. This combination is taught by National Jewish Health in Denver, Colorado—a leading lung hospital. Their method involves inhaling medicated mist and exhaling into the Aerobika, which creates lung vibrations. They believe this helps the saline mist penetrate deeper into the airways.


Alternatively, specialists like Dr. Pamela McShane recommend a different sequence: nebulizing first to coat the airways with saline, followed by tools like the Aerobika, vibration vests, or breathing techniques to mobilize mucus.


So, which method do I use? It depends. If I have plenty of time, I’ll nebulize first. If I’m in a hurry, I’ll attach the nebulizer cup to my Aerobika to save time.


The key takeaway is that airway clearance isn’t one-size-fits-all. We shouldn’t compare ourselves to others or feel like we’re doing something wrong if one technique doesn’t work for us.


One tip from experts: avoid exhaling too forcefully or coughing harshly to expel mucus. Doing so can cause floppy airways to collapse, making it harder to clear our lungs. Instead, aim for slow, steady breaths—easy does it.


Do you have a preferred method? Share your experience below!


(BE CLEAR has a consulting relationship with Monaghan Medical)


#bronchiectasis #airwayclearance #removingmucus #phlegm #sputum #nebuliser #Aerobika