Lung Cleaning Device: Is it a Scam?

Lung cleaning devices are used in pulmonary rehabilitation in healthcare settings for patients with respiratory problems. Lately, an Australian company is offering a device called the AirPhysio, saying it’s “like an OPEP device, but much more efficient”.

Key takeaways:
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    Most healthy patients with normal lung function will experience minimal if any benefit from regular use of an OPEP or OPEP-like device.
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    OPEP devices use the general principle of opening the airways and using airway oscillations to loosen mucus. Specific devices differ in their mechanism, pressure pulse waveforms, and how they work overall.
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    OPEP devices seem to benefit those patients with both chronic pulmonary disease and a concurrent lower respiratory illness the most.
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    OPEP devices will aid in clearing mucus and improving airflow by positive airway pressure, but they do not eliminate respiratory pathogens such as bacteria or viruses.
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    Evidence from large clinical studies is lacking for the use of OPEP devices for adjunct therapy with the management of COPD and COPD exacerbations.

To back up, as a general rule, healthy patients with normal respiratory function do not need to use a lung cleaning device or undergo pulmonary rehabilitation.

The basis of pulmonary rehabilitation is clinically sound with a long history of clinical management and health maintenance for patients who have a chronic respiratory disease. Chest physiotherapy is used to improve the movement and removal of airway secretions in patients with respiratory problems.

A type of device used in chest physiotherapy is OPEP therapy, which stands for Oscillating Expiratory Pressure. It is a non-invasive, drug-free method that is meant to assist patients with chronic respiratory conditions.

Patients who are struggling with clearing mucus use OPEP devices. These include patients who have been diagnosed with COPD, cystic fibrosis, chronic bronchitis, asthma, and other disorders. It should not be used in cases where there is tuberculosis, heart failure, and pneumothorax.

It is unclear how effective OPEP devices are for normal people. It is unclear whether normal adults need “lung cleaning”.

The device made in Australia is essentially an OPEP device. This article will cover the ins and outs of lung cleaning devices such as the AirPhysio. In particular, it will attempt to answer the question: Is it a scam?

What are the goals of pulmonary rehabilitation?

First and foremost, pulmonary rehabilitation is aimed at reducing symptoms for those patients who have disabilities due to respiratory problems. It is aimed at improving physical and social activity, and therefore working toward an improved quality of life.

Pulmonary rehabilitation is done through a coordinated effort with the patient, their family and friends, and their healthcare team. Pulmonary rehabilitation is aimed at solving a patient’s unique problems. Each person is different.

It is unproven for patients who may have a normal respiratory function or for those recovering from an acute, not chronic, illness.

What are the benefits of OPEP therapy?

OPEP works to support airway clearance.

Positive expiratory pressure therapy (PEP) works by preventing the collapse of the airways and increasing what air is left in the lungs or functional residual capacity.

OPEP is a form of PEP, but it also works using airway vibrations or oscillations. It is supposed to be more effective than PEP and has been used in patients initially with cystic fibrosis, asthma, and bronchitis. The success of using OPEP in these severe respiratory conditions made OPEP widely popular.

Unfortunately, only a few research studies have shown OPEP to be helpful in patients with lower respiratory tract illnesses. OPEP devices use positive pressure and oscillation. They work by shifting the air pressure in the airways and by preventing airway collapse. They allow for “lung cleaning” or mobilizing mucus and secretions.

The concept of using an OPEP device is to drain the mucus, improve oxygenation, and reduce inflammation in the airways. It does nothing to eliminate the pathogens such as bacteria or viruses. It is unlikely the device performs any function at all in patients without a respiratory infection. And as stated, even in those patients with respiratory infections, it is likely of little benefit.

Who gets the most out of using an OPEP or lung-cleaning device?

Patients with hypersecretory conditions such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis get the most use out of OPEP or a lung cleaning device.

The devices can be cleaned and reused. Careful attention should be given to disinfecting the devices.

It is unlikely that in a healthy person, using an OPEP will “strengthen the lungs” unless the patient has a chronic illness such as COPD, asthma, cystic fibrosis, bronchiectasis, or other conditions.

The OPEP devices on the market are generally safe if used properly. Studies still need to be done to determine long-term efficacy in patients with COPD and other chronic conditions.

What about using an OPEP device in patients with COVID-19?

Using an OPEP device can likely be beneficial to select patients, particularly those with respiratory distress such as with severe COVID-19 pneumonia or with a concomitant diagnosis of COPD.

Pulmonary rehabilitation is indicated for patients with acute and chronic respiratory impairment, particularly those who have shortness of breath, reduced exercise tolerance, restriction of activities, and poor oxygen levels.

It should be noted that pulmonary rehabilitation overall should be limited if it will cause risk during exercise training. OPEP devices may exacerbate existing conditions such as angina or recent myocardial infarction.

Individualized plans of care should always be undertaken when advising patients on using respiratory rehabilitation techniques.

There is significant clinical overlap between patients with chronic bronchitis, emphysema, COPD, and asthma. These patients with various signs and symptoms may benefit from an OPEP device, especially amid COVID pneumonia.

It is unlikely that any lung cleaning device offered for sale on the market will help a healthy person clean their airways. Used in a healthcare setting, an OPEP device is a non-invasive, drug-free method meant to assist patients with chronic respiratory conditions.

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