Key takeaways

  • Flutter valves are handheld devices that help people with chronic obstructive pulmonary disease (COPD) clear excess mucus from their airways.
  • They work by combining positive expiratory pressure with vibrations to move secretions into larger airways so they can be coughed out.
  • The device requires daily cleaning with warm, soapy water to prevent infection risk. A person should speak with a doctor about whether this device is right for them.

Flutter valves are devices that help clear excess secretions from the airways by increasing the airflow behind secretions and moving them into the main airways. This helps a person expel secretions through coughing.

Flutter valves are most commonly used by people with chronic obstructive pulmonary disease (COPD) to help manage symptoms.

This article discusses the Flutter valve for COPD, including the risks, as well as instructions for use and storage. It also examines the difference between a Flutter valve and an Acapella valve.

The Flutter valve helps people with respiratory conditions, such as COPD, cough up mucus. Excess or thick mucus can be difficult to cough up and clear out of the airways.

According to a 2021 review, the aim of this device is to remove excess secretions and help decrease airway obstruction.

Flutter valves are an airway clearance technique categorized as positive expiratory pressure (PEP), which involves exhaling against resistance. It combines PEP with back-and-forth movements called high frequency oscillations.

While PEP increases airflow behind secretions, oscillations produce vibrations within the bronchial walls, which move secretions into the bronchial opening. The bronchial tubes are the two large airways that connect the windpipe to the right and left lungs.

The Flutter valve’s oscillating PEP system also encourages secretions to move from the smaller airways into the bronchial tubes.

Once secretions move into the bronchial opening, a person can cough them out. The authors of the 2021 review note that PEP systems, such as the Flutter valve, are effective at managing the early stages of COPD.

Some other benefits of airway clearance techniques include:

  • preventing respiratory tract infections
  • improving the gas exchange of carbon dioxide and oxygen in the lungs
  • expanding a collapsed area of the lung
  • reducing inflammatory response in the airways

Pharmacies carry Flutter valves, but a doctor’s prescription is required to purchase one.

The Acapella device also uses the oscillating PEP to help clear a person’s airways, and both devices can help manage the same conditions.

One distinction between the devices is that the Flutter valve relies on gravity, while the Acapella valve does not. People must be in an upright position to use the Flutter valve, but may not have to be in this position if using the Acapella device.

The Acapella device may also produce higher oscillation frequencies at lower pressure levels than the Flutter device.

The biggest risk of using a Flutter valve for COPD is infection, including pneumothorax and hemoptysis.

Pneumothorax is the presence of air in the cavity between the chest wall and lungs, which can cause the organ to collapse. Hemoptysis is when a person coughs up blood from their lungs.

Medical Perspective

“A person should ask a doctor about a Flutter device if they are having difficulty expectorating mucus. If they feel mucus in their chest, but they cannot easily expel it, a Flutter device may be very helpful.”

— Thomas Johnson, PA-C

Learn more about when to see a doctor about a cough.

Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

To use a Flutter valve:

  1. Get into an upright position.
  2. Inhale, or take in a deep breath through the nose.
  3. Put the mouthpiece in the mouth in a horizontal position, and close the lips tightly around it to create a tight seal. Hold breath for 2 to 3 seconds.
  4. Perform a long, steady exhalation, letting out the breath into the device.
  5. Adjust the resistance to create the most vibration felt in the lungs.
  6. Repeat up to 10 times.
  7. End the session with 1 to 2 full-capacity inhalations followed by maximal exhalations through the device.
  8. Cough strongly 2 to 3 times and spit out mucus.

A 2017 study found that using a Flutter valve for 30 minutes daily for 4 weeks can be beneficial.

However, a person should speak with a healthcare professional, such as a pulmonologist, about the best treatment for them, as this may vary from person to person.

A person should clean the Flutter device daily to prevent the risk of infection. To clean the device:

  1. Take apart the device following the instructions in the instruction manual.
  2. Soak the device parts in warm, soapy water for 15 minutes.
  3. Take each piece out of the water, rinse, and shake off excess water.
  4. Allow the parts to dry on a clean, dry towel.
  5. When dry, put the device back together and store it in a clean place.

How often a person needs to use a Flutter valve depends on several factors, such as the type and severity of their lung condition.

For instance, older research found that using a Flutter valve once daily for 4 weeks was effective for managing symptoms of bronchiectasis.

However, healthcare professionals may recommend using the Flutter valve multiple times daily if a person produces a lot of thick mucus.

A person breathes into (exhales) a Flutter valve.

The Flutter valve for COPD is a device that clears secretions from the airways, helping prevent respiratory infections and improving lung function. It works similarly to other airway clearance techniques.

The device uses an oscillating PEP system to increase airflow behind secretions and move them into the opening of the bronchial tubes. This allows secretions to be cleared through coughing.

There may be some risks associated with using a Flutter device, so a person may want to talk with a healthcare professional to see if one would work for them.