Airway Clearance Techniques (ACTs) and tips.

Although cystic fibrosis (CF) can affect many organs, it mainly affects the lungs. People with CF have very thick mucus. This makes it hard for mucus to move in and out of the lungs and keep the airways clear.

One of the most important things you can do for your lungs is to do your airway clearance techniques, or ACTs, on a regular basis. There are many different types of ACTs.

Below are some of the most commonly used ACTs and how they help to clear the airways and make breathing easier:

• Chest Physiotherapy or Postural Drainage with Percussion
  Uses gravity to drain secretions from various parts of the lung. Helps loosen mucus from smaller airways and move it to larger airways where it can be coughed up.
• Positive Expiratory Pressure (PEP)
  By creating positive pressure during expiration, airflow is allowed beneath areas of mucus obstruction and moves the mucus to larger airways to be removed.
• Active Cycle Breathing Technique (ACBT)
  Used to mobilize and clear excess bronchial secretions. There are three parts of active cycle breathing technique:
  1. Breathing control
  2. Chest expansion exercises
  3. Forced expiration technique
• Oscillating Positive Expiratory Pressure (OPEP)
  Vibrates large and small airways, thinning, dislodging and moving mucus.
• Intrapulmonary Percussive Ventilation (IPV)
  Uses compressed gas to deliver a series of small, pressurized gas bursts to the respiratory tract airway.
• High Frequency Chest Wall Oscillation (HFCWO)
  Pressure in a vest rapidly increases and decreases producing cough-like forces that help break up mucus.
• Autogenic Drainage (AD)
  Also called self-drainage, it uses varied airflows to move mucus. The aim is to use very high airflows in different lung parts to move mucus from small to large airways.
• Mechanical Insufflator-Exsufflator
  Delivers a deep breath through a mask.

Work with your CF treatment center to find the ones that are right for you. Your treatment center will suggest the ACTs based on:

• Your lifestyle
• Daily schedule
• Other factors

Your treatment center will teach you the techniques so you can do them at home the right way. ACTs are often combined with medications, such as antibiotics and bronchodilators. In general, take bronchodilators before ACTs. Use inhaled antibiotics after ACTs. Follow the routine as instructed by your treatment center.

Doing ACTs can improve your breathing, but it takes time and patience. If your daily schedule is crunched for time, talk to your CVS Specialty CF CareTeam or pharmacy. They can suggest ways to make the routine fit into your life, and be consistent. Call your CF CareTeam at 1-866-845-6790 if you have any questions about your medications or ACTs.