The Efficacy of Breathing Exercise With BreatheMAX Device on Airway Secretion Clearance and Lung Function

Inclusion Criteria: * Intubated patients (with and without mechanical ventilator support) with secretion 1.5 ml/h, If the patients are breathing with mechanical ventilation, the PEEP level must be less than 6 centimeter of water and one of following * Clinical and radiologic diagnosis of pulmonary infection * Acute or chronic airway inflammation disease such as pneumonia, bronchiectasis, chronic obstructive pulmonary disease or chronic bronchitis and at least one sign of secretion accumulation in bronchial such as medium-coarse crackle, wheezing, persistent rhonchi and decrease breath sound * Stable of cardiopulmonary function at least 2 days before the study and the patients don't receive the vasopressors drug within 5 days before collects the data * Stable of hydration status or positive fluid balance at least 2 days before collects the data * Ability to breathe or tolerate spontaneously breathing trial with T-piece at least 2 minutes with fraction of inspired oxygen less than 0.4 and without developing hypoxemia * Good conscious and well cooperation Exclusion Criteria: * Pneumothorax (nontreated) * Massive hemoptysis * Acute myocardial infarction (with angina chest pain) * High intracranial pressure (\>20 mm Hg) * Major arrhythmia