Initial mechanical ventilation settings: Difference between revisions
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== Initial == | == Initial == | ||
*FiO2 100% and ween down | |||
*Rate 8-12/min | |||
**consider 5-6 for asthma w/ permissive hypercapnea | |||
*[[Ventilation (Main)|Mode]] | |||
**A/C = defalt (most) | |||
**SIMV = with obstructive airway disease and an intact respiratory effort (e.g. some COPD, asthma) | |||
**PC = with intact respiratory effort and non-severe respiratory failure (prefered in chronic vent) | |||
*PEEP 0-5 mmH20 | |||
*TV 5-8 cc/kg (eg. 500-600cc) | |||
**(adjust to plateau pressure <35 cmH20) | |||
*I/E 1:3 | |||
*PS (pressure support) 5-8cm to overcome ET | |||
===Table=== | ===Table=== | ||
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=== O2 === | === O2 === | ||
*PaO2 (ween to SaO2 >90% & PaO2 >60) | |||
*FiO2 (ween to <0.5 if poss) | |||
*PEEP (see ARDS schedule; if >10, should have art line) | |||
**(rule of 7s: decrease 1 FiO2 = 7 pO2) | |||
=== CO2 === | === CO2 === | ||
*PCO2 | |||
**TV | |||
**Rate | |||
*(VE-1 x pCO2-1 = VE-2 x pCO2-2) | |||
**VE = minute ventilation (RR x TV) | |||
=== pH === | === pH === | ||
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== MISC (normally already set) == | == MISC (normally already set) == | ||
*Inspiratory flow rate = 60L/min (100L/min with asthma) | |||
*Sensitivity = 1-2 cmH2O | |||
== See Also == | == See Also == | ||
Revision as of 18:56, 14 May 2015
Initial
- FiO2 100% and ween down
- Rate 8-12/min
- consider 5-6 for asthma w/ permissive hypercapnea
- Mode
- A/C = defalt (most)
- SIMV = with obstructive airway disease and an intact respiratory effort (e.g. some COPD, asthma)
- PC = with intact respiratory effort and non-severe respiratory failure (prefered in chronic vent)
- PEEP 0-5 mmH20
- TV 5-8 cc/kg (eg. 500-600cc)
- (adjust to plateau pressure <35 cmH20)
- I/E 1:3
- PS (pressure support) 5-8cm to overcome ET
Table
| Disease | TV^ | RR | I:E | PEEP |
| Nl lung | 8 | 10-12 | 1:2 | 4 |
| Obstruct | 6 | 5-8 | 1:4 | 4 |
| ARDS | 6 | 12-20 | 1:2 | 2-15 |
| Hypovol | 8 | 10-12 | 1:2 | 0-4 |
^cc/kg
^^FiO2 always = 1.0
See also Ventilation (Strategies)
Changes
O2
- PaO2 (ween to SaO2 >90% & PaO2 >60)
- FiO2 (ween to <0.5 if poss)
- PEEP (see ARDS schedule; if >10, should have art line)
- (rule of 7s: decrease 1 FiO2 = 7 pO2)
CO2
- PCO2
- TV
- Rate
- (VE-1 x pCO2-1 = VE-2 x pCO2-2)
- VE = minute ventilation (RR x TV)
pH
to increase pH 0.01 --> decrease pCO2 by 1
MISC (normally already set)
- Inspiratory flow rate = 60L/min (100L/min with asthma)
- Sensitivity = 1-2 cmH2O