The importance of airway clearance for bronchiectasis

When it comes to naturally clearing your airways, three things need to happen to effectively remove mucus and contaminants from your lungs:

A normal amount of mucus is secreted to trap harmful substances
The mucus is continuously swept from your lower to upper airways
Coughing clears the mucus from your respiratory system

With bronchiectasis (BE), your airways become enlarged, scarred, and unable to function normally, impairing natural airway clearance.

Break the vicious cycle

When mucus can’t be cleared from the lungs effectively, it builds up and creates an environment where bacteria can grow. This can lead to repeated, serious lung infections that cause more damage to the airways, beginning a vicious cycle of infection. This cycle may lead to irreversible lung damage and respiratory failure.

Improving quality of life

Although there’s no cure for BE, early detection and treatment can prevent further lung damage and allow people to have a better quality of life. Of course, as with your general health, living a healthy lifestyle is also important.

The goal of BE treatment is to help manage symptoms and prevent both flare-ups and infections. A combination of therapies may be recommended and prescribed, including:

Medication
Antibiotics
Mucus thinners
Chest physical therapy (CPT) or physiotherapy, which percusses the chest to help loosen mucus
Postural drainage, which uses gravity to help drain mucus from your lungs
Breathing techniques

There are also several types of airway clearance devices that may be prescribed for BE, including:

Hand-held positive expiratory pressure (PEP) devices or percussors that vibrate the chest from the outside
Wearable “vest therapy” that provides high frequency chest wall oscillation (HFCWO) to help loosen and remove mucus

How does vest therapy work?

Vest therapy uses HFCWO to effectively treat all areas of your lungs by helping move mucus upwards so that it’s easier to cough out
The vest rapidly oscillates against your chest, gently compressing and releasing the chest wall to create increased airflow within the lungs
This loosens, thins, and moves mucus toward the larger airways where it can be cleared by coughing or suctioning
Reducing mucus buildup in the lungs helps reduce the frequency of infection and hospitalizations while also helping prevent further lung damage
Vest therapy does not require special skills—most people are able to perform it on their own; and vest therapy is hands-free, so it can be used while doing other activities

Grandmother knitting on couch

HFCWO therapy is shown to improve health outcomes and improve quality of life^1-3

Types of vest therapies

Air Vest Therapy

Air vest therapy works by sending a gentle, oscillating airflow into an inflatable garment. This rapidly compresses and releases the chest wall, oscillating airflow within the airways. It also:

Is used in the comfort of your home
Is portable, allowing you to move it to your preferred location within your home

Mobile Vest Therapy

This therapy also works by a wearable garment creating gentle oscillations, rapidly compressing and releasing the chest wall to oscillate airflow within the airways. It also:

Is used in the comfort of your home
Is battery powered, giving you added freedom to move around during therapy

Other Helpful Resources

Anatomy of a cough in 3D animation

The Vest^® Airway Clearance System 3D Animation

Airway clearance anatomy and physiology explained

Monarch System in 3D animation

References

Basavaraj, M. DeKoven, D. Shah, et al. Impact of High Frequency Chest Wall Oscillation on Clinical Outcomes and Healthcare Resource Utilization in Adult Patients with Non-Cystic Fibrosis Bronchiectasis in the United States: A Pre-Post Cohort Analysis. American Journal of Respiratory and Critical Care Medicine 2020;201:A7758.
Sievert, CE et al. 2018. Incidence of Bronchiectasis-Related Exacerbation Rates After High Frequency Chest Wall Oscillation (HFCWO) Treatment – A Longitudinal Outcome-Based Study. Respiratory Therapy, 13(2), 38-41.
Nicolini A, Cardini F, Landucci N, et al. Effectiveness of treatment with high-frequency chest wall oscillation in patients in patients with bronchiectasis. BMC Pulm Med 2013: Apr 4;13:21. doi: 10.1186/1471-2466-13-21.