Auto-PEEP and Physical Exam

Q: Physical examination can exclude but cannot confirm auto-PEEP?

A) True
B) False


Answer: False

Physical exam of the chest in patients who are on mechanical ventilation can confirm auto-PEEP but cannot exclude auto-PEEP. Careful auscultation, as well as palpation, may demonstrate continued expiratory airflow from the previous breath when the next breath is triggered by a mechanical ventilator.


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.