Pulmonary Hygiene is a general term that includes exercises and methods which clear airway and lung from obstructive secretions Also called Pulmonary toilet. This term is also called pulmonary hygiene or bronchopulmonary hygiene. Deep breathing, lung exercises, and tapping on the chest are some of the commonly used pulmonary toilet methods.

Thanks to the Pulmonary Hygiene application, the capacity of the lungs is expanded and your body gets enough oxygen. Also, the respiratory system works more efficiently.

The pulmonary hygiene procedure has not been fully proven to be a definitive treatment approach. However, there are positive feedbacks that these methods make it easier to breathe for many patients who have lung diseases.

Who Is Suitable For Pulmonary Hygiene?

Pulmonary Hygiene methods are a complementary treatment approach for diseases and conditions that cause mucus secretions such as chronic lung diseases, respiratory problems, and bacterial infections (pneumonia).

People who have breathing problems due to fluids accumulating in the respiratory tract can try these methods with instructions of healthcare providers.

Pulmonary toilet methods can be effective for the following diseases and conditions leading to breathing difficulties:

  • COPD (Chronic obstructive pulmonary disease)
  • Bronchiectasis
  • Cystic fibrosis
  • Bronchitis
  • Pneumonia
  • Asthma
  • Emphysema
  • Muscular dystrophy

We can divide hygiene methods and processes into two. Some of these approaches can be applied at home without the help of someone else. Some require medical attention so it is necessary to visit the medical institutions.

Pulmonary Hygiene Techniques & Methods

Pulmonary Hygiene

1. Deep Breathing

While the deep breathing technique will give you the habit of breathing efficiently, it will also make it easier for you to remove the secretions such as mucus that is stuck in your respiratory tract and throw it out of the body.

  1. First, relax your neck and shoulders.
  2. Put one hand on your stomach with the palm facing your stomach.
  3. Exhale very slowly through your mouth
  4. Breathe as deeply as possible and feel that the air reaches your stomach.
  5. Repeat this process periodically at least ten times a day

When applying this method, you can also cough up obstructive secretions in your lungs.

2. Controlled Coughing

Controlled coughing is one of the most effective Pulmonary Hygiene methods for airway clearance in lung disease. A healthcare provider will teach you the proper way to sit and how to cough to make it productive.

3. Huffing

Huffing is a highly effective Pulmonary Hygiene strategy. Thanks to the vibrations it creates, it enables us to remove the respiratory fluids, which make breathing difficult, from where they are located.

It can be applied in two different ways:

  1. Take a normal breath, then exhale as strongly as possible.
  2. Take a deep breath, then exhale with short, sharp breaths. (intermittently)

4. Incentive Spirometry

The most important benefits of incentive spirometry are strengthening your lung muscles and increasing your breathing capacity.

All you need for this method is an incentive spirometer. There are different variations of this tool consisting of one or three cylinders Inside these cylinders include tiny balls. Also this spirometer has a flexible tube with a mouthpiece through which you’ll exhale and inhale.

When you use your incentive spirometer, a tiny ball or other indicator goes up and down inside the spirometer, depending on how much you can exhale. Your healthcare provider may help you on how to use the device properly.

Spirometry is very important for who is in the recovery process after surgery or who has a respiratory condition, such as pneumonia. It provides patients to re-strengthen their weak lungs.

How to use incentive spirometry:
  1. Take the incentive spirometer in your hand
  2. Exhale fully before you begin
  3. Place the mouthpiece in your mouth and seal your lips tightly around it
  4. Breathe in slowly and deeply
  5. Hold your breath for at least five seconds
  6. Exhale slowly and relax
  7. You repeat this ten times

We recommend that you perform this procedure 4 times a day at regular intervals.

5. Chest Percussion

Percussion is a type of physical therapy used to clean the respiratory tract in many lung diseases. It is also as known as cupping or clapping. It helps to excrete the mucus secretion which is one of the most obvious problems of COPD disease from the lungs.

You can usually do this Pulmonary Hygiene method at home. At the same time, it also can be performed using electronic devices or other instruments that vibrate your chest.

You will need someone to help you when applying chest percussion. The person to apply this method may be a relative or a professional respiratory therapist.

How to apply percussion:

Chest percussion is applied by striking the chest or back with cupped hands. The vibration created by this movement helps to break up thick secretions in the lungs. You can learn this technique from a healthcare professional.

if you are skinny or have any heart conditions, this method may not be ideal for you. Also, it is also beneficial to consult your healthcare provider before applying chest percussion.

6. Chest Vibration

Vibration is one of the pulmonary hygiene methods similar to percussion. Again, hands contact the lungs during application. But the palms are flatter in this technique.

The person performing the method puts the palm of one hand on your chest or back. The other hand is also placed on top of it. Then, they are moved by the therapist rapidly side to side to create a vibration.

This method helps to loosen secretions in the lungs.

7. Postural Drainage

This Pulmonary Hygiene procedure takes advantage of gravity to clean your airway. It is especially applied in the morning to get rid of fluids that accumulate in your lungs overnight.

The postural drainage can be applied in different body positions. Several pillows are required to support the positions. Each position is ideal for clearing secretion in different areas. Postural drainage is often performed along with chest percussion, which breaks up mucus in the lungs. If you are a master of the process, you can apply it at home.

You will need support to learn how to use it. A physical therapist or respiratory therapist can explain to you exactly how to position yourself for this procedure.

8. Suction

This pulmonary hygiene method is among the medical strategies. A medical device is used for this process. Also, suction treatment can be performed by a physical therapist or a respiratory therapist.

Suction is the process of pulling the fluids in the respiratory tract by providing a vacuum. The strong air removes them, then a flexible tube pulls them out of the body.

This method may seem a bit uncomfortable. However, it is completed in a very short time(about 10 seconds). If you need more than one session at a time, you’ll get a break in between each one.

Are Pulmonary Hygiene Methods Safe?

Pulmonary Toilet

Pulmonary Hygiene techniques are very safe and useful methods. But it is important that you have to know how to apply these methods in a proper way.

Several methods are only performed in hospitals or clinics. So you may need to visit a physical therapist or respiratory therapist to perform some of your pulmonary hygiene treatments.

For safety, you should also learn how to perform Pulmonary Hygiene methods before you perform at home. Besides, it might be beneficial to bring a family member or other caregivers with you to the appointment so they can learn how to help.

Pulmonary hygiene can be a useful part of your treatment plan, but make sure to keep up with the main treatments prescribed by your doctors.


The health of the members of the pulmonary hypertension (PH) community is always the Pulmonary Hypertension Association’s (PHA’s) top concern. Read on to discover how to maintain your health, tips for daily living during the pandemic, COVID-19 updates and ways to connect with PHA.

COVID-19 Frequently Asked Questions for the Pulmonary Hypertension Community (updated 5/11/2020)

The COVID-19 outbreak is causing significant concern worldwide and especially within the Pulmonary Hypertension (PH) community. The Pulmonary Hypertension Association (PHA) has prepared these Frequently Asked Questions (FAQ) to address many of the questions and concerns that we have heard from the PH community regarding COVID-19. This includes information from Centers for Disease Control and Prevention (CDC) on the risk to people with underlying health conditions and the steps you can take to protect yourself and your family. Please call your PH physician or care provider if youare feeling unwell or have further questions.

Q: Are people with PH at greater risk for COVID-19 virus infection?
A: According to the CDC, there is no evidence to suggest that people with underlying health conditions are at higher risk of becoming infected with the COVID-19 virus. However, there is evidence that people with underlying health conditions, including all types of heart and lung diseases, have a higher risk of developing serious illness from the COVID-19 virus if they become infected. It is currently unknown whether the risk of COVID-19 virus infection is higher in PH patients compared to the general population. Researchers and clinicians are gathering information through PHA-accredited PH
Care Centers to understand the impact of COVID-19 on PH patients.

Q: What safety precautions should I take as a PH patient?
A: These are challenging times and require some rethinking of approaches to daily living. Individuals should consult their PH health care teams with specific questions about personal health risks and safety.

The CDC has provided guidelines for people who are at higher risk. PHA recommends that you check the CDC website frequently for the most current guidelines. The CDC guidelines include:

  • Stay at home as much as possible to reduce your risk of being exposed.
  • Avoid crowds.
  • Keep space between yourself and others. It is recommended to keep at least 6 feet apart from others. Avoid large crowds or heavy traffic areas.
  • Limit close contact to other people who are sick.
  • Frequently wash your hands with soap for at least 20 seconds or use hand sanitizer with at least 60% alcohol content.
  • Avoid touching your face, especially your eyes, mouth and nose.
  • Avoid all non-essential travel, even short trips.
  • The CDC currently recommends covering your mouth and nose with a cloth face cover when around others. Everyone should wear a face covering in public settings such as the grocery store or pharmacy.
  • Cloth face coverings should not be used on young children under 2 years old and anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
  • The recommended face coverings are not surgical masks or N-95 respirators which must continue to be reserved for health care workers and other first responders.
  • The CDC provides instructions on how to wear face coverings, how to make homemade cloth face covers, how to safely remove used face covers and how to safely clean cloth face covers.
  • Continue to keep 6 feet between you and others. Cloth face coverings are not a substitute for social distancing.

People with PH and those close to them should continue taking precautions to keep themselves healthy and follow the CDC’s guidance for those at higher risk.