Q: How Auto-PEEP can be suspected by physical exam?


Answer: Auto-PEEP can be detected by auscultation of the chest. During Auto-PEEP, inspiratory airflow will be heard before the expiratory airflow ceases. Actually, it can also be palpated with hands on the chest. Confirmation can be done by auscultation of the expiratory valve of the ventilator and listening for persistence of airflow at end-expiration.


Reference: 

Kress JP, O'Connor MF, Schmidt GA. Clinical examination reliably detects intrinsic positive end-expiratory pressure in critically ill, mechanically ventilated patients. Am J Respir Crit Care Med 1999; 159:290.