Question
What is the benefit of autogenic drainage?
Answer
- No equipment needed
- Can perform airway clearance as an independent procedure
- Less coughing effort is needed for sputum production
In the past mainly, this was done for cystic fibrosis patients, but it is not only for those patient populations. In the 1980s, the autogenic drainage technique was used throughout Europe for the treatment of patients with asthma who had retention of secretions in the chest and difficulty in clearing the secretions. You do not have to look for equipment, nor is it required. PEP devices, acapella, and vest equipment are not needed. We teach a technique that has been lost in many of the therapy of today because there is much equipment out there. The patient can perform airway clearance as an independent procedure. We know that many patients, if they are weaker, have trouble with their cough, and they are not able to cough effectively as you would think. With this procedure, it requires less coughing because you are going to move the secretions with the technique, and in order to get it to the areas or "zones" that you need to get to, you will not have to cough as effortfully. It is almost like the PEP device where you can do the huff maneuver that would cause you to cough as well. We will talk about it when we get to that section.
Anyone with retained secretions is eligible to do autogenic drainage. Retained secretions will decrease flow and lung volume, causing atelectasis and other complications. We are teaching the patient to do this technique to move their secretions from the lower airway until it gets to the upper airway. It sounds like a lot, but once you do it a few times, the patient gets it down. It is not as hard as it looks, but the first time you ever do it might be challenging. This is for the patient to learn how to move secretions independently, which I think is a big deal if you can teach them how to do it. We know what will happen once the secretions get to the upper airway when the coughing mechanism occurs, and we can have them cough up the sputum. When we get to the coughing section, we will discuss the huff maneuver and the huff cough. This is also going to be a part of the autogenic drainage.
This Ask the Expert is an edited excerpt from the course, Autogenic Drainage: Technique for Airway Clearance, presented by Duane Reed, EdD, RRT, RCP.
