Q: Nurse called you to evaluate an intubated patient, who is desaturating. Patient is admitted for community acquired pneumonia and required intubation. Patient is on FiO2 100% and PEEP of 7. You decided to slowly increase PEEP to get saturation more than 90%. As you increase PEEP progressively to 13, patient starts coughing. Is this a good sign or a bad sign?

Answer: Good sign

Any lung recruitment maneuvers followed by cough is a good sign. This is a good sign resulting from expansion of collapsed lung.