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)
#  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 ==
#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 &lt;35 cmH20)
#I/E 1:3
#PS (pressure support) 5-8cm to overcome ET
 
===Table===


{| cellspacing="1" cellpadding="1" border="1" width="200"
{| cellspacing="1" cellpadding="1" border="1" width="200"
|-
|-
| '''Disease'''
| '''Disease'''  
| '''TV^'''
| '''TV^'''  
| '''RR'''
| '''RR'''  
| '''I:E'''
| '''I:E'''  
| '''PEEP'''
| '''PEEP'''
|-
|-
| Nl lung
| Nl lung  
| 8
| 8  
| 10-12
| 10-12  
| 1:2
| 1:2  
| 4
| 4
|-
|-
| Obstruct
| Obstruct  
| 6
| 6  
| 5-8
| 5-8  
| 1:4
| 1:4  
| 4
| 4
|-
|-
| ARDS
| ARDS  
| 6
| 6  
| 12-20
| 12-20  
| 1:2
| 1:2  
| 2-15
| 2-15
|-
|-
| Hypovol
| Hypovol  
| 8
| 8  
| 10-12
| 10-12  
| 1:2
| 1:2  
| 0-4
| 0-4
|}
|}


<br>


^cc/kg


^cc/kg
^^FiO2 always = 1.0
 
== Changes ==
 
=== O2 ===


^^FiO2 always = 1.0
#PaO2 (ween to SaO2 &gt;90% &amp; PaO2 &gt;60)
#FiO2 (ween to &lt;0.5 if poss)
#PEEP (see ARDS schedule; if &gt;10, should have art line)
##(rule of 7s: decrease 1 FiO2 = 7 pO2)


==Changes==
=== CO2 ===
===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  
#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 ===
to increase pH 0.01 --> decrease pCO2 by 1


==MISC (normally already set)==
to increase pH 0.01 --&gt; decrease pCO2 by 1
# Inspiratory flow rate = 60L/min (100L/min with asthma)
 
# Sensitivity = 1-2 cmH2O
== MISC (normally already set) ==
 
#Inspiratory flow rate = 60L/min (100L/min with asthma)  
#Sensitivity = 1-2 cmH2O
 
== See Also ==


==See Also==
*[[Vent (General)]]  
*[[Vent (General)]]  
*[[Vent (Weaning)]]
*[[Vent (Weaning)]]  
*[[Ventilation (Non-Invasive)]]  
*[[Ventilation (Non-Invasive)]]  
*[[Ventilator Management]]
*[[Ventilator Management]]


==Source==
== Source ==
2/8/06 DONALDSON (adapted from emedicine, Lampe)  
 
2/8/06 DONALDSON (adapted from emedicine, Lampe)  


[[Category:Airway/Resus]]
[[Category:Airway/Resus]] [[Category:Pulm]]
[[Category:Pulm]]

Revision as of 21:14, 22 July 2011

Initial

  1. FiO2 100% and ween down
  2. Rate 8-12/min (consider 5-6 for asthma w/ permissive hypercapnea)
  3. Mode
    1. A/C = defalt (most)
    2. SIMV = with obstructive airway disease and an intact respiratory effort (e.g. some COPD, asthma)
    3. PC = with intact respiratory effort and non-severe respiratory failure (prefered in chronic vent)
  4. Peep 0-5 mmH20
  5. TV 5-8 cc/kg (eg. 500-600cc) (adjust to plateau pressure <35 cmH20)
  6. I/E 1:3
  7. 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

Changes

O2

  1. PaO2 (ween to SaO2 >90% & PaO2 >60)
  2. FiO2 (ween to <0.5 if poss)
  3. PEEP (see ARDS schedule; if >10, should have art line)
    1. (rule of 7s: decrease 1 FiO2 = 7 pO2)

CO2

  1. PCO2
    1. TV
    2. Rate
  2. (VE-1 x pCO2-1 = VE-2 x pCO2-2)
    1. VE = minute ventilation (RR x TV)

pH

to increase pH 0.01 --> decrease pCO2 by 1

MISC (normally already set)

  1. Inspiratory flow rate = 60L/min (100L/min with asthma)
  2. Sensitivity = 1-2 cmH2O

See Also

Source

2/8/06 DONALDSON (adapted from emedicine, Lampe)

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