Ventilation (Strategies): Difference between revisions

Revision as of 02:48, 23 May 2011

2. Tidal Volume (lung protection)
- Start 6-8cc/kg ideal body wt
  - Titrate down if peak pressure >30

3. Inspiratory Flow Rate (comfort)
- More comfortable if higher rather than lower
- Start at 60-80 LPM

4. Respiratory Rate (CO2)
- Avg pt on ventilator requires 120mL/kg/min for eucapnia
- Start 16-18 breaths/min
- Maintain pH = 7.30-7.45

5. FiO2/PEEP (O2)
- Move in tandem to achieve:
  - SpO2 BETWEEN 88-95%
  - PaO2 BETWEEN 55-80

FiO2	0.3	0.4	0.4	0.5	0.5	0.6	0.7	0.7	0.7	0.8	0.9	0.9	0.9	1.0	1.0	1.0
PEEP	5	5	8	8	10	10	10	12	14	14	14	16	18	20	22	24

EMCrit Vent Lecture

Authors:

@@ Line 1: / Line 1: @@
 == Lung Injury Strategy ==
 === Background ===
 *Ok for all pts except for obstructed
 === Settings ===
 *1. Mode
 **Assist control
@@ Line 21: / Line 17: @@
 **Avg pt on ventilator requires 120mL/kg/min for eucapnia
 **Start 16-18 breaths/min
+**Maintain pH = 7.30-7.45
 *5. FiO2/PEEP (O2)
@@ Line 27: / Line 24: @@
 ***PaO2 BETWEEN 55-80
-{| border="1" cellspacing="1" cellpadding="1" style="width: 500px; "
+{| border="1" cellspacing="1" cellpadding="1" style="width: 500px;"
 |-
 | FiO2
@@ Line 67: / Line 64: @@
+==Source==
+EMCrit Vent Lecture
+[[Category:Pulm]]
-Inclusion criteria:
-ARDS defined as PaO2/FiO2 ratio <300, bilateral alveolar infiltrates on CXR, no evidence of CHF
-Treatment:
-) TV 6cc/kg ideal body weight
-) Increased PEEP with decreased FiO2-->
-)
-Adjust to:
-) pH = 7.3-7.45 adjust rate (6-35) prn
-) PaO2 = 55-80 (or SaO2 = 88-95%)
-Outcome: decreased mortality & #days on the ventilator
-/2/06 DONALDSON (adapted from Lampe; NEJM May 200?)
-<br/>[[Category:Pulm]] <br/><br/>