ventilation strategies for ARDS includes low tidal volume, high peep, target plateau pressure of 30

• related: ARDS acute respiratory distress syndrome, ICU intensive care unit
• tags: #permanent

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Notes

Ventilation strategies for ARDS includes PEEP, tidal volume, and plateau pressure.

• Use low tidal volume, use 4 to 8 cc/kg ideal body weight. Target 6 cc/kg¹
  • make sure to measure patients as females under report their height and males overreport
  • table for low tidal volume mechanical ventilation and PEEP FiO2
• Target plateau pressure < 30 cm H2O
• Target permissive hypercapnia with pH > 7.2

Using high PEEP and initial 6 cc/kg tidal volume can cause elevated plateau pressure. If plateau pressure is above 30 with initial setting, first check to make sure there is no ventilator desynchrony that could be minimized by increasing sedation. Next decrease tidal volume to 5 and then 4 cc/kg. Decreasing TV can cause more respiratory acidosis that could be offset by increasing respiratory rate or sodium bicarb (try not to use).

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Source

• women under report their height and can thus be over ventilated

Plateau Pressure

PEEP

Links to this note

• ARDS acute respiratory distress syndrome
  • ventilation strategies for ARDS includes low tidal volume, high peep, target plateau pressure of 30

Footnotes

1. Acute Respiratory Distress Syndrome Network, Brower RG, Matthay MA, et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1301-1308. doi:10.1056/NEJM200005043421801 https://www.nejm.org/doi/full/10.1056/nejm200005043421801 ↩