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AUTOGENIC DRAINAGE
Autogenic drainage was developed by Chevaillien in 1960’s. Autogenic drainage is a respiratory self drainage technique using controlled expiratory airflow to mobilise secretions.
There are 3 phases of Autogenic drainage
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Unsticking phase - Unstick phase is loosening at the lung secretions by breathing at low lung volumes. The air movement is slow and deep.
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Collecting phase - It collects the secretions to central airways by breathing at low to mid lung volumes. The air movement is slow and mid range air movement.
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Evacuating phase - It is expelling out the secretions from central airways by breathing at mid to high lung volume. The air movement is shallow in this phase.
PROCEDURE
Preparation of patient:
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Patient in relax position: Sit or recline with neck slightly extended.
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Clear the nose and throat.
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Teach the correct breathing pattern.
Phase 1: Unstick
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Exhale completely.
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Inhale small / Normal breaths.
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Hold 1-3 seconds.
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Exhale completely.
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Repeat: 1-3 minutes (until crackles are heard during expiration)
Phase 2: Collect
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Inhale mid volume breaths.
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Hold 1-3 seconds.
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Exhale but not completely.
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Repeat 1-3 minutes (until crackles are heard at end of expiration)
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Continue 2-3 times more.
Phase 3: Evacuate
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Take a slow deep breath.
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Hold for 1-3 seconds.
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Exhale forcefully (with open glottis) HUFF ( mucus moves to oral cavity )
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Spit out.
Precautions:
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Do not cough / HUFF until last phase.
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Relax with breath control.
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Procedure should be gentle.
Rationale of Autogenic drainage:
The technique generates shearing forces induced by airflow. The speed of expiratory flow mobilises the secretions by shearing them from the bronchial walls and transporting them from peripheral to central airways.
Advantages:
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No equipment required.
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Can be self administrate.
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Less effort required.
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Low intensity.
Disadvantages:
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Not suitable for paediatric patients
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Difficult to teach.
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Needs good cognitive level.