RT Formulas

Vent management 6

Formulas3

ARDSnet Info

Disclaimer: Intended for educational use only. Not intended for use in place of professional judgement. Please refer to http://www.ardsnet.org for updated information of ARDSNet protocols and inclusion criteria
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Inclusion

ARDS Inclusion Criteria

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Vent Setup

Vent setup and Adjustment

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ph Goal

ph Goal: 7.30-7.45

Acidosis management (pH < 7.30)

Increase RR until pH > 7.30 or PaCO2 < 25 (Maximum set RR = 35)

Severe Acidosis (pH <7.15)

  • Increase RR to 35
  • If pH remains <7.15 VT may be increased in 1ml/kg steps until pH >7.15 (Pplat target of 30 may be exceeded)
  • May give NaHCO3

Alkalosis Management (pH >7.45)

Decrease vent rate if possible

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Oxygenation Goal

Oxygenation Goal: PaO2 55-80 or SpO2 88-95%

FiO2 PEEP
0.3 5
0.3 8
0.3 10
0.3 12
0.3 14
0.4 14
0.4 16
0.5 16
0.5 18
0.5-0.8 20
0.8 22
0.9 22
1.0 22
1.0 24
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Pplat Goal: <30

Check Pplat (0.5sec plat) at least q4 and after each change in PEEP or VT

Pplat > 30cmH2O

decrease VT by 1ml/kg steps (minimum = 4ml/kg)

Pplat < 25 cm H2O &
VT < 6ml/kg

Increase VT by 1 ml/kg until
Pplat > 25 cm H2O or VT = 6 ml/kg.

Pplat < 30 and breath stacking
or dys-synchrony occurs

may increase VT in 1ml/kg increments to 7 or 8 ml/kg if Pplat remains < 30 cmH2O