What You Should Know About Bibasilar Crackles

Medically reviewed by Carissa Stephens, RN, BSN, CPN, CCRN on April 6, 2016Written by Annette McDermott on April 6, 2016

What are bibasilar crackles?

Have you ever wondered what your doctor is listening for when he puts a stethoscope against your back and tells you to breathe? They’re listening for abnormal lung sounds such as bibasilar crackles, or rales. These sounds indicate something serious is happening in your lungs.

Bibasilar crackles are a bubbling or crackling sound originating from the base of the lungs. They may occur when the lungs inflate or deflate. They’re usually brief, and may be described as sounding wet or dry. Excess fluid in the airways causes these sounds.

What symptoms can occur with bibasilar crackles?

Depending on the cause, bibasilar crackles may occur with other symptoms. These symptoms can include:

  • shortness of breath
  • fatigue
  • chest pain
  • the sensation of suffocation
  • a cough
  • a fever
  • wheezing
  • swelling of the feet or legs

What are the causes of bibasilar crackles?

Many conditions cause excess fluid in the lungs and may lead to bibasilar crackles.

Pneumonia

Pneumonia is an infection in your lungs. It may be in one or both lungs. The infection causes air sacs in your lungs to become pus-filled and inflamed. This causes a cough, difficulty breathing, and crackles. Pneumonia may be mild or life-threatening.

Bronchitis

Bronchitis occurs when your bronchial tubes become inflamed. These tubes carry air to your lungs. The symptoms may include bibasilar crackles, a severe cough which brings up mucus, and wheezing.

Viruses, such as the cold or flu, or lung irritants usually cause acute bronchitis. Chronic bronchitis occurs when bronchitis doesn’t go away. Smoking is the main cause of chronic bronchitis.

Pulmonary edema

Pulmonary edema may cause crackling sounds in your lungs. People with congestive heart failure (CHF) often have pulmonary edema. CHF occurs when the heart cannot pump blood effectively. This results in a backup of blood, which increases blood pressure and causes fluid to collect in the air sacs in the lungs.

Some non-cardiac causes of pulmonary edema are:

  • lung injury
  • high altitudes
  • viral infections
  • smoke inhalation
  • near drowning

Interstitial lung disease

The interstitium is the tissue and space that surrounds the air sacs of the lung. Any lung disease that impacts this area is known as interstitial lung disease. It may be caused by:

  • occupational or environmental exposures, such as asbestos, smoking, or coal dust
  • chemotherapy
  • radiation
  • some medical conditions
  • certain antibiotics

Interstitial lung disease usually causes bibasilar crackles.

Additional causes

Although not as common, bibasilar crackles may also be present if you have chronic obstructive pulmonary disease (COPD) or asthma.

A 2008 study showed that lung crackles may be related to age in some asymptomatic cardiovascular patients. Although more research is needed, the study found that after the age of 45, the occurrence of crackles tripled every 10 years.

Diagnosing the cause of bibasilar crackles

Your doctor uses a stethoscope listens to you breathe and to listen for bibasilar crackles. Crackles make a similar sound to rubbing your hair between your fingers, near your ear. In severe cases, crackles may be heard without a stethoscope.

If you have bibasilar crackles, your doctor will take your medical history and possibly order diagnostic tests to look for the cause. These tests can include:

  • a chest X-ray or CT scan of the chest to view your lungs
  • blood tests to check for an infection
  • sputum tests to help find the cause of infection
  • pulse oximetry to measure your blood oxygen level
  • an electrocardiogram or echocardiogram to check for heart irregularities

Treating the cause of bibasilar crackles

Getting rid of crackles requires treating their cause. Doctors usually treat bacterial pneumonia and bronchitis with antibiotics. A viral lung infections often has to run its course, but your doctor may treat it with antiviral medications. With any lung infection, you should get plenty of rest, stay well-hydrated, and avoid lung irritants.

If crackles are due to a chronic lung condition, you’ll need to make lifestyle changes to help control your symptoms. If you smoke, quit. If someone in your home smokes, ask them to quit or insist they smoke outside. You should also try to avoid lung irritants such as dust and molds.

Other treatments for chronic lung disease may include:

  • inhaled steroids to reduce airway inflammation
  • bronchodilators to relax and open your airways
  • oxygen therapy to help you breathe better
  • pulmonary rehabilitation to help you stay active

If you have a lung infection, finish taking your medication, even if you feel better. If you don’t, your risk of getting another infection increases.

Surgery may be an option for people with advanced lung disease not controlled by medication or other treatments. Surgery may be used to remove infection or fluid buildup, or to remove a lung altogether. A lung transplant is a last resort for some people.

Other remedies

Since they may be caused by a serious condition, you shouldn’t treat bibasilar crackles or any lung symptoms on your own. You should contact your doctor for a proper diagnosis and treatment recommendation.

If your doctor diagnoses you with a lung infection due to a cold or flu, these home remedies may help you feel better:

  • a humidifier to put moisture in the air and to relieve a cough
  • hot tea with lemon, honey, and a dash of cinnamon to help relieve a cough and fight infection
  • steam from a hot shower or a steam tent to help loosen phlegm
  • a healthy diet to boost your immune system

Over-the-counter medications may help relieve symptoms such as a cough and fever. These include ibuprofen (Advil) and acetaminophen (Tylenol). You can use a cough suppressant if you aren’t coughing up mucus.

What are the risk factors?

The risk factors for bibasilar crackles depend on their cause. In general, several things put you at risk for lung problems:

  • smoking
  • having a family history of lung disease
  • having a workplace that exposes you to lung irritants
  • being regularly exposed to bacteria or viruses

Your risk of chronic lung disease increases as you age. Your risk of interstitial lung disease may increase if you’ve been exposed to chest radiation or chemotherapy drugs.

What is the outlook?

When pneumonia or bronchitis is the cause of your bibasilar crackles and you see your doctor early on, your outlook is good and the condition is often curable. The longer you wait to get treatment, the more severe and serious your infection may become. Untreated pneumonia may become life-threatening.

Other causes of crackles, such as pulmonary edema and interstitial lung disease, may require long-term treatment and hospitalization at some point. These conditions can often be controlled and slowed down with medications and lifestyle changes.

It’s also important to address the causes of the disease. The earlier you begin treatment, the better your outlook. Contact your doctor at the first signs of lung infection or lung disease.

Preventing bibasilar crackles

Follow these tips to promote lung health and help prevent bibasilar crackles:

  • Don’t smoke.
  • Limit your exposure to environmental and occupational toxins.
  • If you must work in a toxic environment, cover your mouth and nose with a mask.
  • Prevent infection by washing your hands frequently.
  • Avoid crowds during the cold and flu season.
  • Get a pneumonia vaccine.
  • Get a flu vaccine.
  • Exercise regularly.
CMS Id: 101711