ACTIVE

CYCLE
BREATHING
TECHNIQUE

By
E .Ram kumar (b.p.t 3 rd year ‘e’ sec)
 DEFINITION

AIM : TO CLEAR BRONCHIAL SECETIONS

The Active Cycle of Breathing Techniques (ACBT) is an

active breathing technique performed by the patient.
It can be used to mobilize and clear excess pulmonary
secretions and to generally improve lung function
(OR)
ACBT is one way to help clear sputum from your chest. It is
a set of breathing exercises that loosens and moves sputum
from your airways.
 THE CYCLE

EFFECTS OF ACBT

Loosen and clear secretions from the lungs.

Improve ventilation in the lungs.
Improve the effectiveness of a cough .
 PHASES OF ACBT

1. Breathing Control
2. Deep Breathing Exercises (or) Thoracic Expansion
Exercises
3. Huffing or Forced Expiratory Technique (FET)
 PREPARATION OF PATIENT

To maintain good breathing pattern with relaxed shoulder

and neck
Avoid using your accessory muscle during the acbt
Free from tension
If patient have a more sputum or sputum seek in
the lung parts to use nebulizer for patient
comfortable
 POSITION OF PATIENT

HIGH SITTING : Less Secretion

Alternate side lying with postal drainage : More Secretion

 ACB TECHNIQUE BREATHING CONTROL
(RELAXED BREATHING)
3-5 BREATH
20-30 SECONDS

USES: Used to relax the airways

Breathing control is breathing gently, using as little effort as possible.
 Rest your hand on your rib cage/upper abdomen. Feel your upper
abdomen rising under your hand as you breathe in and falling as you
breathe out.
Try to breathe in through your nose then out through your nose or mouth.
 Breathe at a rate which feels comfortable; the rate will slow as you relax
 Shoulder relaxed position and Breathing control should continue until the person
feels ready to progress to the other stages in the cycle
 DEEP BREATHIING
STEP-2 THORACIC EXPANSION
3-5 BREATHS
USES:This helps loosen secretions.
 Take 3 to 5 long, slow, deep breaths in, through your nose if you can.
Pause at the end of each breath in for 2-3 seconds, then breathe out gently
through your mouth, like a sigh. Try to keep your shoulders and chest
relaxed
You should repeat steps 1 and 2 several times before moving on to step 3 .
 HUFFING
STEP-3
FORCED EXPIIRATORY TECHNIQUE
1-2 HUFF
USES: Huffing helps moves sputum from the small airways to the larger
airways, from where they are removed by coughing.as coughing alone
can not remove sputum from small airways

THERE ARE TWO TYPES OF HUFF

MEDIUM VOLUME HUFF

This helps to move secretions that are lower down in your airways .
Take a normal-sized breath in and then an active, long breath out until
your lungs feel quite empty. Imagine you are trying to steam up a mirror
 HIGH VOLUME HUFF
 this helps move secretions in your upper airways.
 Take a deep breath in, open your mouth wide and huff out
quickly.
Only perform 1-2 huffs together, as repeatedly huffing can
make your chest feel tight.
 Listen for ‘crackles’ when you huff. If you hear these, you may
now need to cough and clear secretions; try to spit them out into
a tissue or pot. Try to avoid excessive coughing as this may
reduce how effective the technique is and make it excessively
tiring.
 Repeat the whole cycle for about 10-15 minutes or until your
chest feels clear.
COUGHING
Coughing should be incorporated if huffing alone does not clear your
sputum. However, if it does clear your sputum, then you may not need to
cough.
ACBT CYCLE

BREATHING CONTROL DEEP BREATHING HUFFING

THORACIC EXPANSION
 DURATION

Duration for ACBT should be for about 10 -15 minutes

ideally until your chest feels clear of sputum.

FREQUENCY

You may need to do ACBT only once or twice a day when you are
well. When you have more sputum, you may need to do it more
often. When you are unwell or have more sputum, you may need to
do shorter and/ or more frequent sessions].
 ACBT-B

ACBT-C
ACBT-A
(PROGRESSIVE STAGE)
(INITIAL STAGE)
 INDICATIONS CONTRAINDICATIONS

1. Post surgical /pain (rib fracture).

2. Acute increase sputum production. 1. Patients not spontaneously
3. Poor expansion. breathing
2. Unconscious patient
4. Sputum RetentIon.
3. Patients who are unable to follow
5. Cystic Fibrosis .
instructions
6. Bronchiectasis . 4. Agitated or confused
7. Respiratory muscle weakness 5. Positioning
8. Asthma .
9. Increased breathing rate/effort
10. Audible rattling in airways
 PRECAUTION

■ It is important to constantly assess for dizziness or increased shortness

of breath throughout ACBT.
■ If a patient feels dizzy during deep breathing, decrease the number of
deep breaths taken during each cycle and return to breathing control to
reduce dizziness[13].
COMPLICATION
•Bronchospasm with hyper-reactive airways
•Reduced oxygen saturations/ shortness of breath
•Cardiac arrhythmias
•Atelectasis
•Fatigue
 PHYSIOLOGY THORACIC EXPANSION

FUNCTION:LOOSEN SECRETIONS FUNTION:RE-EXPANSION OF LUNG

REASON:3 CHANNELS REASON:EXPANDING FORCES OF
RESISTANCE REDUCED ALVEOLI ARE GREATER THAN THE
TIDAL VOLUME

AIRFLOW THROUGH CHANNELS

 PHYSIOLOGY HUFFING

EPP is a point in the airways where the air

way pressure is equal to the pleural pressure.
A huff continue to low lung volume shift the EPP more
peripherally, which mobilizes more peripheral secretions.
ACBT CYCLE
 BRONCHIECTASIS
CASE /TECHNIQUE EVIDENCE AND
CYSTIC FIBROSIS