Ventilator Settings
1. Mode
2. Tidal volume
4-6ml predicted body weight patient with ARDS.
6-8ml predicted body weight patient with ARDS.
Predicted body weight formulae;
PBW (Males);
50 + (0.91 × [height in centimeters − 152.4]
PBW (females);
45.5 + (0.91 × [height in centimeters − 152.4]).
For example;
Male; Height in cm- 122 PWB- 22.4kg tidal volume-90 (4ml/kg)
3. Respiratory rate
4. I:E ratio (Inspiratory:expiratory ratio)
Normal inspiratory:expiratory ratio;1:2
To calculate an I E ratio, divide the total inspiratory time by the total expiratory time.
For example; If patient take 6-second breath cycle, break down to 2 seconds of inspiration and 4 seconds of expiration.
Changing the I:E ratio to 1:3, result in 1.5 seconds of inspiration and 4.5 seconds of expiration.
(expiration takes longer than inspiration).
5. PEEP (Positive end-expiratory pressure)
positive pressure remain in the airways at the end of the respiratory cycle (end of exhalation), greater than atmospheric pressure in mechanically ventilated patients.
Types of PEEP
1. Extrinsic PEEP (PEEP applied by a ventilator)
2. Intrinsic PEEP (PEEP caused by an incomplete exhalation)
PEEP reduces trauma to the alveoli and prevent alveolar collapse.
Clinical benefit of 'high PEEP' in patients with acute respiratory distress syndrome (ARDS).
PEEP is an intervention used to keep the alveoli open.
PEEP is pressure applied by ventilator at end of each breath to ensure alveoli are not prone to collapse.
6. Trigger sensitivity
Trigger sensitivity trigger determines how much effort the patient has to exert before his inspiration that trigger breathe from ventilator.
Sensitive control determines how much effort the patient must take generate in order to trigger a breathe from machine.
7. Pressure support
Pressure support provides preset amount of pressure during inspiration to support the spontaneously breathing patient.
Ability to overcome the resistance of endotracheal tube and is often used during weaning because it decreases the effort of breathing.
The patient initiates every breath and the ventilator delivers support with the preset pressure value. With support from the ventilator, the patient also regulates his own respiratory rate and tidal volume.
Ventilator Alarm setting
1. Pressure Alarm
High Pressure
Low Pressure
2. Volume Alarm
Low Volume
3. High Frequency
4. Apnea Alarm
Apnea
5. PEEP alarm
High PEEP
Low PEEP
6. Increased respiration rate
7. Plateau pressure
Plateau pressure is determined using an end-inspiratory pause. There is not airflow in the circuit. That is when inspiration is complete.
8. Peak inspiratory pressure
Peak inspiratory pressure is the highest level of pressure applied to the lungs during inhalation.
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