As PEEP is increased, it helps to recruit collapsed alveoli to improve gas exchange and oxygenation. Minimal PEEP of 5 cm H 2O is used in all patients on mechanical ventilation to prevent end expiratory alveolar collapse. Generally preferred at < 60% to decrease risk of oxygen toxicity Too low RR can cause hypoventilation (respiratory acidosis) Incremental air trapping in each successive breath causing auto-PEEP a Too low TV can cause atelectasis, and hypoventilation (respiratory acidosis) With percussion, more vibration is felt (increased tactile fremitus).Ģ Note: in ARDS the recommend TV is not more than 6 cc/kg of predicted body weight.Ĭan increase intrathoracic pressure resulting in decreased venous return to heart, thereby. With auscultation, patient’s spoken words and whispered sounds are heard louder (termed as bronchophony and whispering pectoriloquy, respectively) Stridor = noisy breathing (often so loud that it can be heard without a stethoscope)ĭue to incomplete upper or middle-respiratory tract obstructionĪThese exam findings are due to increased conduction of vibration by consolidated lung. Interstitial lung disease (Velcro crackles) Interstitial lung disease with bibasilar predominance (Velcro-crackles) Generalized bronchiectasis Localized bronchiectasisįluid accumulation in alveoli due to congestive heart failure Parasympathomimetics (e.g., organophosphate poisoning) Increased breath sounds (inspiration and expiration equally heard = bronchial breath sounds)Ĭonsolidation of lung segments due to lobar pneumonia Additional findings include: Pneumothorax (additional finding is tympanic sound on percussion) Pleural effusion (additional finding is dullness to percussion)
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