Autogenous drainage is a modulation of respiratory flow (inhalation and exhalation) that allows mucus in the airways to be mobilized, collected and aspirated. The patient has to slowly inhale with an open glottis (for optimal air distribution), an amount of air goes through which carries air behind the mucus (the less we inhale, the deeper we go). The patient then maintains a breather of 2 to 3 seconds with open glottis to further optimize the distribution of air in the lungs (passage through the collaterals and filling of the vertices). Finally, it generates an exhalation flow fast and deep enough to loosen the mucus and move it upwards, always open glottis. Beware, if the patient works hard, he will close the smallest airways by creating a pressure increase and will only work at a high lung volume. Respiratory flows should always be modulated based on the location of the mucus (high, medium or low volume) and the condition of the bronchi (inflammation, spasticity, bronchiectasis, etc.). Instrumental aids are at our disposal to generate a better flow (flutter, aerobika, pep, IPV, bipap, acapella). Different bands are also used to lower the patient volume and/or to correct any thoracic deformities.

The lung defecation is completed by clearing the upper respiratory tract. It is very important to flush the upper airways daily because 80-90% of the bacteria found there are also found in the lungs. For patients aged 4-5 years, the nose is rinsed with Lotha (can, watering can, content 400ml, etc.) filled with a lukewarm physiological serum. For the little ones, we use 100 ml pipettes, also filled with lukewarm physiological serum. If necessary, medications such as antibiotics can be added to physiological saline. This is sometimes not sufficient and in addition to the classic flush, the patient will do an aerosol of the BL, usually true sinus par.

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