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| == Lung Injury Strategy ==
| | #REDIRECT[[Initial mechanical ventilation settings]] |
| === Background ===
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| *Ok for all pts except for obstructed
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| === Settings ===
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| *1. Mode
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| **Assist control Volume
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| *2. Tidal Volume (lung protection)
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| **Start 6-8cc/kg ideal body wt
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| ***Titrate down if peak pressure >30
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| | |
| *3. Inspiratory Flow Rate (comfort)
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| **More comfortable if higher rather than lower
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| **Start at 60-80 LPM
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| | |
| *4. Respiratory Rate (CO2)
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| **Avg pt on ventilator requires 120mL/kg/min for eucapnia
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| **Start 16-18 breaths/min
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| **Maintain pH = 7.30-7.45
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| | |
| *5. FiO2/PEEP (O2)
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| **Move in tandem to achieve:
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| ***SpO2 BETWEEN 88-95%
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| ***PaO2 BETWEEN 55-80
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| | |
| {| border="1" cellspacing="1" cellpadding="1" style="width: 500px;"
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| |-
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| | FiO2
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| | 0.3
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| | 0.4
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| | 0.4
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| | 0.5
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| | 0.5
| |
| | 0.6
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| | 0.7
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| | 0.7
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| | 0.7
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| | 0.8
| |
| | 0.9
| |
| | 0.9
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| | 0.9
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| | 1.0
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| | 1.0
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| | 1.0
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| |-
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| | PEEP
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| | 5
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| | 5
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| | 8
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| | 8
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| | 10
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| | 10
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| | 10
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| | 12
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| | 14
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| | 14
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| | 14
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| | 16
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| | 18
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| | 20
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| | 22
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| | 24
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| |}
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| ==Obstruction Strategy==
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| ===Background===
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| Goal = Adequate time for expiration
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| ===Settings===
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| *1. Mode
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| **Assist Control Volume
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| | |
| *2. Tidal Volume
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| **Vt = 8 cc/kg ideal body wt
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| | |
| *3. Inspiratory Flow Rate
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| **Set at 80-100 LPM to allow more expiration time
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| | |
| *4. FiO2/PEEP
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| **Titrate FiO2 to desired SpO2
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| **Set PEEP 0-4
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| *5. Respiratory Rate
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| **Set low - 10 BPM
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| **Adjust for I:E 1:4 or 1:5
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| **Permissive hypercapnia to avoid breath stacking
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| ***Ok as long as pH > 7.00-7.10
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| ***Maintain plateau pressure <30
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| ****If >30 go down on rate
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| | |
| ==See Also==
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| [[Vent (General)]] | |
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| [[Vent (Initial - Changes)]]
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| [[Vent (Weaning)]]
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| [[Ventilation (Non-Invasive)]]
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| | |
| ==Source==
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| EMCrit Vent Lecture
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| | |
| [[Category:Airway/Resus]]
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| [[Category:Pulm]]
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