From the Guidelines
When a healthcare provider states "lungs are clear," it indicates that the lungs are functioning normally with no evidence of abnormalities, and this finding should be considered alongside other symptoms and health factors for a complete clinical picture. This assessment is typically made through a combination of physical examination, including listening with a stethoscope, and reviewing imaging studies. A clear lung finding suggests healthy respiratory function, with normal air movement through the airways and proper gas exchange in the alveoli. According to the American College of Radiology, chest CT is not recommended for the initial evaluation of patients presenting with chronic cough, unless the more common causes are excluded or empirically treated 1.
Some key points to consider when evaluating lung health include:
- The presence of normal breathing sounds without wheezing, crackles, or rhonchi
- No evidence of fluid accumulation, inflammation, infection, masses, or obstructions in the lung tissue
- The use of imaging studies, such as chest radiography or CT scans, to confirm the absence of abnormalities
- The importance of considering other symptoms and health factors, such as medical history and risk factors, to provide a complete clinical picture. For example, a study published in the European Respiratory Journal found that a normal physical examination is common in mild COPD, but signs of the disease can become apparent as it progresses 1.
In terms of the use of imaging studies, a chest CT scan is considered the reference standard for the noninvasive diagnosis of bronchiectasis and interstitial lung disease 1. However, the evidence suggests that wide application of chest CT in all patients presenting with chronic cough may be of low clinical yield, and appropriate selection would likely improve the specificity of findings 1.
Overall, a clear lung finding is a positive indication of respiratory health, but it should be considered in the context of the patient's overall clinical picture, including their medical history, symptoms, and other health factors.
From the Research
Lungs are Clear
- This means there's no evidence of fluid buildup, inflammation, or other abnormalities in the lung tissue.
- According to 2, a study on long-term pulmonary sequelae in adolescents post-SARS-CoV-2 infection, spirometry was normal in 77% of patients, indicating no abnormalities in lung function.
- Another study 3 discusses the use of systemic corticosteroids for treating respiratory diseases, which may be relevant in cases where lung inflammation is present, but not directly related to the concept of "lungs are clear".
Diagnostic Measures
- Monitoring respiratory values such as breathing frequency, pattern, and effort is crucial in identifying potential respiratory issues, as stated in 4.
- A study on diagnosis and management of acute respiratory failure 5 highlights the importance of early diagnostic maneuvers, such as measurement of SpO2 and arterial blood gas, to differentiate the type of respiratory failure and guide next steps in evaluation and management.
Treatment and Management
- Inhaled corticosteroids have been investigated for the treatment of COVID-19, and a study 6 found that they probably reduce admission to hospital or death and increase resolution of all initial symptoms at day 14 in people with mild COVID-19.
- However, the use of systemic corticosteroids, as discussed in 3, requires careful consideration of dosage and duration to minimize potential side effects.