Difference between revisions of "Initial mechanical ventilation settings"

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== Initial ==
 
== Initial ==
  
#FiO2 100% and ween down  
+
*FiO2 100% and ween down  
#Rate 8-12/min
+
*Rate 8-12/min
##consider 5-6 for asthma w/ permissive hypercapnea
+
**consider 5-6 for asthma w/ permissive hypercapnea
#[[Ventilation (Main)|Mode]]  
+
*[[Ventilation (Main)|Mode]]  
##A/C = defalt (most)  
+
**A/C = defalt (most)  
##SIMV = with obstructive airway disease and an intact respiratory effort (e.g. some COPD, asthma)  
+
**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)  
+
**PC = with intact respiratory effort and non-severe respiratory failure (prefered in chronic vent)  
#PEEP 0-5 mmH20  
+
*PEEP 0-5 mmH20  
#TV 5-8 cc/kg (eg. 500-600cc)  
+
*TV 5-8 cc/kg (eg. 500-600cc)  
##(adjust to plateau pressure <35 cmH20)  
+
**(adjust to plateau pressure <35 cmH20)  
#I/E 1:3  
+
*I/E 1:3  
#PS (pressure support) 5-8cm to overcome ET
+
*PS (pressure support) 5-8cm to overcome ET
  
 
===Table===
 
===Table===
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=== O2 ===
 
=== O2 ===
  
#PaO2 (ween to SaO2 >90% & PaO2 >60)  
+
*PaO2 (ween to SaO2 >90% & PaO2 >60)  
#FiO2 (ween to <0.5 if poss)  
+
*FiO2 (ween to <0.5 if poss)  
#PEEP (see ARDS schedule; if >10, should have art line)  
+
*PEEP (see ARDS schedule; if >10, should have art line)  
##(rule of 7s: decrease 1 FiO2 = 7 pO2)
+
**(rule of 7s: decrease 1 FiO2 = 7 pO2)
  
 
=== CO2 ===
 
=== CO2 ===
  
#PCO2  
+
*PCO2  
##TV  
+
**TV  
##Rate  
+
**Rate  
#(VE-1 x pCO2-1 = VE-2 x pCO2-2)  
+
*(VE-1 x pCO2-1 = VE-2 x pCO2-2)  
##VE = minute ventilation (RR x TV)
+
**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)  
+
*Inspiratory flow rate = 60L/min (100L/min with asthma)  
#Sensitivity = 1-2 cmH2O
+
*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

See Also

Source