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.
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ReplyDeleteThis summary of the Kress study is fascinating; it really emphasizes how vital clinical palpation remains even with modern ventilators. It’s a reminder that hands-on diagnostics are essential, which is why I never skip my annual physical exam forest hills.
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