Improvement of Ventilation. It is obvious that measures to improve ventilation in the patient with CAL are of primary importance, and perhaps that is why so many ways have been devised to facilitate the flow of air to and from the lungs. Breathing is most difficult during the expiratory phase, making it difficult to remove trapped air and secretions. In addition, the bronchial walls are weakened in patients with emphysema and are subject to collapse. Health status and physical condition at the time the technique is used will affect the choice of method and its effectiveness.
Hydration is considered especially valuable in improvement of ventilation.
Inhaled air should be moist so as to thin the secretions for removal and soothe the irritated mucous membranes. Oral intake of fluids is also important. The method of aerosol delivery depends on the ability of the patient to breathe deeply so that the medication reaches the lower segments of the respiratory tract. Controlled deep breathing patterns are especially helpful in emptying the lungs and providing adequate ventilation. The patient with CAL is taught to expand the lower chest and to use the accessory muscles and diaphragm to improve the breathing pattern.