Difference between revisions of "Template:Lung Protective Ventilator Settings"

(Created page with "===Lung Protective Ventilator Settings<ref>EBQ:ARDSnet|The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tid...")
 
(/* Lung Protective Ventilator SettingsThe Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respirat...)
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#'''Mode'''
 
#'''Mode'''
 
#*Volume-assist control
 
#*Volume-assist control
#'''Tidal Volume (lung protection)'''
+
#'''Tidal Volume'''
#*Start 6-8cc/kg [[ideal body weight estimation|predicted body weight]]
+
#*Start 6-8cc/kg [[ideal body weight estimation|predicted body weight]]<ref>Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.</ref>
 
#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.
 
#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.
 
#*Titrate down if peak pressure >30 mmHg
 
#*Titrate down if peak pressure >30 mmHg
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#*SpO2 BETWEEN 88-95%
 
#*SpO2 BETWEEN 88-95%
 
#*PaO2 BETWEEN 55-80
 
#*PaO2 BETWEEN 55-80
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 +
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**Limit barotrauma to healthy area of lung
 +
**Increase PEEP to improve oxygenation
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***High FiO2 can cause absorptive atelectasis<ref>O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.</ref>
 +
***Ardsnet PEEP/FiO2 [http://www.ardsnet.org/files/ventilator_protocol_2008-07.pdf protocol card]<ref>Kallet RH, et al. "Respiratory controversies in the critical care setting. Do the NIH ARDS Clinical Trials Network PEEP/FIO2 tables provide the best evidence-based guide to balancing PEEP and FIO2 settings in adults?" Respiratory Care. 2007. 52(4):461-75.</ref>

Revision as of 19:22, 21 March 2020

Lung Protective Ventilator Settings[1]

  1. Mode
    • Volume-assist control
  2. Tidal Volume
    • Start 6-8cc/kg predicted body weight[2]
      • Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.
    • Titrate down if peak pressure >30 mmHg
  3. Inspiratory Flow Rate (comfort)
    • More comfortable if higher rather than lower
    • Start at 60-80 LPM
  4. Respiratory Rate (titrate for ventilation)
    • Average patient on ventilator requires 120mL/kg/min for eucapnia
    • Start 16-18 breaths/min
    • Maintain pH = 7.30-7.45
  5. FiO2/PEEP (titrate for oxygenation)
    • Move in tandem to achieve:
    • SpO2 BETWEEN 88-95%
    • PaO2 BETWEEN 55-80


    • Limit barotrauma to healthy area of lung
    • Increase PEEP to improve oxygenation
  • The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342(18):1301-1308.
  • Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.
  • O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.
  • Kallet RH, et al. "Respiratory controversies in the critical care setting. Do the NIH ARDS Clinical Trials Network PEEP/FIO2 tables provide the best evidence-based guide to balancing PEEP and FIO2 settings in adults?" Respiratory Care. 2007. 52(4):461-75.