{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:15:33Z","timestamp":1758845733543,"version":"3.41.2"},"reference-count":31,"publisher":"FapUNIFESP (SciELO)","issue":"5","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. bras. pneumol."],"abstract":"<jats:p>ABSTRACT  Objective: To investigate the accuracy of chest auscultation in detecting abnormal respiratory mechanics.  Methods: We evaluated 200 mechanically ventilated patients in the immediate postoperative period after cardiac surgery. We assessed respiratory system mechanics - static compliance of the respiratory system (Cst,rs) and respiratory system resistance (R,rs) - after which two independent examiners, blinded to the respiratory system mechanics data, performed chest auscultation.  Results: Neither decreased\/abolished breath sounds nor crackles were associated with decreased Cst,rs (\u2264 60 mL\/cmH2O), regardless of the examiner. The overall accuracy of chest auscultation was 34.0% and 42.0% for examiners A and B, respectively. The sensitivity and specificity of chest auscultation for detecting decreased\/abolished breath sounds or crackles were 25.1% and 68.3%, respectively, for examiner A, versus 36.4% and 63.4%, respectively, for examiner B. Based on the judgments made by examiner A, there was a weak association between increased R,rs (\u2265 15 cmH2O\/L\/s) and rhonchi or wheezing (\u03d5 = 0.31, p &lt; 0.01). The overall accuracy for detecting rhonchi or wheezing was 89.5% and 85.0% for examiners A and B, respectively. The sensitivity and specificity for detecting rhonchi or wheezing were 30.0% and 96.1%, respectively, for examiner A, versus 10.0% and 93.3%, respectively, for examiner B.  Conclusions: Chest auscultation does not appear to be an accurate diagnostic method for detecting abnormal respiratory mechanics in mechanically ventilated patients in the immediate postoperative period after cardiac surgery.<\/jats:p>","DOI":"10.1590\/1806-3713\/e20180032","type":"journal-article","created":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T19:32:41Z","timestamp":1564255961000},"source":"Crossref","is-referenced-by-count":4,"title":["Accuracy of chest auscultation in detecting abnormal respiratory mechanics in the immediate postoperative period after cardiac surgery"],"prefix":"10.1590","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6098-0747","authenticated-orcid":false,"given":"Glaciele","family":"Xavier","sequence":"first","affiliation":[{"name":"Universidade de Bras\u00edlia,  Brazil; Instituto de Cardiologia do Distrito Federal,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3544-6999","authenticated-orcid":false,"given":"C\u00e9sar Augusto","family":"Melo-Silva","sequence":"additional","affiliation":[{"name":"Universidade de Bras\u00edlia,  Brazil; Hospital Universit\u00e1rio de Bras\u00edlia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9621-2443","authenticated-orcid":false,"given":"Carlos Eduardo Ventura Gaio dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade de Bras\u00edlia,  Brazil; Hospital Universit\u00e1rio de Bras\u00edlia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4253-4935","authenticated-orcid":false,"given":"Veronica Moreira","family":"Amado","sequence":"additional","affiliation":[{"name":"Universidade de Bras\u00edlia,  Brazil; Hospital Universit\u00e1rio de Bras\u00edlia,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2019]]},"reference":[{"issue":"8","key":"ref1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1056\/NEJMra1302901","article-title":"Fundamentals of lung auscultation","volume":"370","author":"Bohadana A","year":"2014","journal-title":"N Engl J Med"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"158","DOI":"10.4103\/1817-1737.160831","article-title":"Auscultation of the respiratory system","volume":"10","author":"Sarkar M","year":"2015","journal-title":"Ann Thorac Med"},{"issue":"6","key":"ref3","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.mehy.2014.09.029","article-title":"Accuracy of pulmonary auscultation to detect abnormal respiratory mechanics a cross-sectional diagnostic study","volume":"83","author":"Xavier GN","year":"2014","journal-title":"Med Hypotheses"},{"issue":"4","key":"ref4","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.rmed.2014.01.004","article-title":"Respiratory sounds in healthy people a systematic review","volume":"108","author":"Oliveira A","year":"2014","journal-title":"Respir Med"},{"issue":"5","key":"ref5","first-page":"400","article-title":"Pulmonary auscultation terminology employed in Brazilian medical journals between January of 1980 and December of 2003","volume":"32","author":"Staszko KF","year":"2006","journal-title":"J Bras Pneumol"},{"issue":"14","key":"ref6","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1121\/1.403655","article-title":"Comparison of the acoustic properties of six popular stethoscopes","volume":"9","author":"Abella M","year":"1992","journal-title":"J Acoust Soc Am"},{"issue":"12","key":"ref7","first-page":"1490","article-title":"Automated lung sound analysis in patients with pneumonia","volume":"49","author":"Murphy R","year":"2004","journal-title":"Respir Care"},{"issue":"6","key":"ref8","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1152\/jappl.1985.58.6.1840","article-title":"Analysis of the behavior of the respiratory system with constant inspiratory flow","volume":"58","author":"Bates J","year":"1985","journal-title":"J Appl Physiol (1985)"},{"issue":"6","key":"ref9","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1007\/BF01706208","article-title":"Intrinsic positive end-expiratory pressure (PEEPi)","volume":"21","author":"Rossi A","year":"1995","journal-title":"Intensive Care Med"},{"issue":"6 Suppl","key":"ref10","first-page":"375S","article-title":"Evidence-based guidelines for weaning and discontinuing ventilatory support a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine","volume":"120","author":"MacIntyre NR","year":"2001","journal-title":"Chest"},{"issue":"9","key":"ref11","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1088\/0967-3334\/30\/9\/003","article-title":"The reliability of lung crackle characteristics in cystic fibrosis and bronchiectasis patients in a clinical setting","volume":"30","author":"Marques A","year":"2009","journal-title":"Physiol Meas"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1007\/s001340051017","article-title":"Effects of open heart surgery on respiratory mechanics","volume":"25","author":"Polese G","year":"1999","journal-title":"Intensive Care Med"},{"issue":"8","key":"ref13","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1097\/00003246-199908000-00008","article-title":"Time-course of impairment of respiratory mechanics after cardiac surgery and cardiopulmonary bypass","volume":"27","author":"Ranieri VM","year":"1999","journal-title":"Crit Care Med"},{"issue":"4","key":"ref14","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1213\/00000539-199710000-00011","article-title":"The systemic inflammatory response to cardiopulmonary bypass pathophysiological, therapeutic, and pharmacological considerations","volume":"85","author":"Hall RI","year":"1997","journal-title":"Anesth Analg"},{"issue":"4","key":"ref15","first-page":"566","article-title":"Anaesthesia and chest wall function","volume":"23","author":"Warner DO","year":"1994","journal-title":"Ann Acad Med Singapore"},{"issue":"3","key":"ref16","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/108925320400800303","article-title":"Pulmonary complications after cardiac surgery","volume":"8","author":"Weissman C","year":"2004","journal-title":"Semin Cardiothorac Vasc Anesth"},{"issue":"1","key":"ref17","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1510\/icvts.2009.222018","article-title":"Influence of lung mechanical properties and alveolar architecture on the pathogenesis of ischemia-reperfusion injury","volume":"11","author":"Silva CA","year":"2010","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"6","key":"ref18","first-page":"935","article-title":"Pleural opening impairs respiratory system compliance and resistance in off-pump coronary artery bypass grafting","volume":"51","author":"Tavolaro KC","year":"2010","journal-title":"J Cardiovasc Surg (Torino)"},{"issue":"5","key":"ref19","first-page":"667","article-title":"Modeling the acoustic properties of the chest and measuring breath sounds","volume":"41","author":"Vovk IV","year":"1995","journal-title":"Acoust Phys"},{"issue":"3","key":"ref20","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1164\/ajrccm.156.3.9701115","article-title":"Respiratory sounds Advances beyond the stethoscope","volume":"156","author":"Pasterkamp H","year":"1997","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"ref21","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/0021-9290(80)90365-6","article-title":"Fluid-dynamic flapping of a collapsible channel sound generation and flow limitation","volume":"13","author":"Grotberg JB","year":"1980","journal-title":"J Biomech"},{"issue":"1","key":"ref22","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1152\/jappl.1988.64.1.17","article-title":"Flow limitation and wheezes in a constant flow and volume lung preparation","volume":"64","author":"Gavriely N","year":"1988","journal-title":"J Appl Physiol (1985)"},{"issue":"5","key":"ref23","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1152\/jappl.1989.66.5.2251","article-title":"Flutter in flow-limited collapsible tubes a mechanism for generation of wheezes","volume":"66","author":"Gavriely N","year":"1989","journal-title":"J Appl Physiol (1985)"},{"issue":"1","key":"ref24","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1164\/ajrccm.159.1.9805011","article-title":"Clinical examination reliably detects intrinsic positive end-expiratory pressure in critically ill, mechanically ventilated patients","volume":"159","author":"Kress JP","year":"1999","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"ref25","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1378\/chest.07-1562","article-title":"Mechanism of inspiratory and expiratory crackles","volume":"135","author":"Vyshedskiy A","year":"2009","journal-title":"Chest"},{"issue":"6891","key":"ref26","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1038\/417809b","article-title":"Physiology Dynamic instabilities in the inflating lung","volume":"417","author":"Alencar AM","year":"2002","journal-title":"Nature"},{"issue":"12","key":"ref27","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1093\/ptj\/75.12.1082","article-title":"Interrater reliability of auscultation of breath sounds among physical therapists","volume":"75","author":"Brooks D","year":"1995","journal-title":"Phys Ther"},{"issue":"11","key":"ref28","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1136\/adc.2003.046458","article-title":"Validity and reliability of acoustic analysis of respiratory sounds in infants","volume":"89","author":"Elphick HE","year":"2004","journal-title":"Arch Dis Child"},{"issue":"8590","key":"ref29","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S0140-6736(88)91613-3","article-title":"Reliability of eliciting physical signs in examination of the chest","volume":"1","author":"Spiteri MA","year":"1988","journal-title":"Lancet"},{"issue":"3","key":"ref30","article-title":"Wheezes, crackles and rhonchi simplifying description of lung sounds increases the agreement on their classification: a study of 12 physicians' classification of lung sounds from video recordings","volume":"28","author":"Melbye H","year":"2016","journal-title":"BMJ Open Respir Res"},{"issue":"1","key":"ref31","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1152\/jappl.1988.64.1.441","article-title":"Flow and volume dependence of pulmonary mechanics in anesthetized cats","volume":"64","author":"Kochi T","year":"1988","journal-title":"J Appl Physiol (1985)"}],"container-title":["Jornal Brasileiro de Pneumologia"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/jbpneu\/v45n5\/1806-3713-jbpneu-45-05-e20180032.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T20:44:33Z","timestamp":1581108273000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1806-37132019000500203&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019]]}},"alternative-id":["S1806-37132019000500203"],"URL":"https:\/\/doi.org\/10.1590\/1806-3713\/e20180032","relation":{},"ISSN":["1806-3756","1806-3713"],"issn-type":[{"type":"electronic","value":"1806-3756"},{"type":"print","value":"1806-3713"}],"subject":[],"published":{"date-parts":[[2019]]},"article-number":"e20180032"}}