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Disclaimer:
Medicine and respiratory therapy are continuously changing
practices. The author and publisher have reviewed all information
in this report with resources believed to be reliable and accurate
and have made every effort to provide information that is up to
date with the best practices at the time of publication. Despite our
best efforts we cannot disregard the possibility of human error
and continual changes in best practices the author, publisher, and
any other party involved in the production of this work can
warrant that the information contained herein is complete or fully
accurate. The author, publisher, and all other parties involved in
this work disclaim all responsibility from any errors contained
within this work and from the results from the use of this
information. Readers are encouraged to check all information in
this publication with institutional guidelines, other sources, and up
to date information. Respiratory Therapy Zone is not affiliated with
the NBRC®, AARC®, or any other group at the time of this
publication.

Copyright ã Respiratory Therapy Zone

2
Table of Contents
Introduction ……………………………………………………………..…………………………………...……..4
Formulas ……………………………………………………………..………………………………..………...……..5
Calculations ……………………………………………………………..………………………………....………..11
Practice Questions ………………………………………….………………………………….…….……..73
TMC Practice Questions …………………………………….……………………..………..….……..80
Conclusion …………………………………………………………..…..……..…………………………...……..85
References …………………………………………………….….……..………..………………………...……..86

Copyright ã Respiratory Therapy Zone

3
Introduction

Are you ready to learn about the Respiratory Therapy Formulas,

Calculations, and Equations? I sure hope so because that is what
this guide is all about.

Inside of this book, we’ve created an all-in-one stop that you can
use as a reference for each and every formula that you’ll see as a
Respiratory Therapy Student.

Some are hard. Some are easy.

But the good news is, I have faith that you can master them all if
you set your mind to it. Practice (and lots of repetitions) makes
perfect. So the more time you spend going through these
formulas, the more likely it is that you’ll actually learn and
memorize this information.

And as you’ll see, we’ve even included some practice questions

that can provide additional help as well.

So if you’re ready, let’s go ahead and dive right in. J

Note: In general, the formulas and calculations may vary from

publication to publication. With that said, we’ve attempted to
provide the ones that will be most helpful for the Respiratory
Therapy Board Exams.

Copyright ã Respiratory Therapy Zone

4
Respiratory Therapy Formulas

First and foremost, before we get into the calculations, let’s first
learn the formulas. These are the formulas and equations that you
will be required to learn in Respiratory Therapy School.

Minute Ventilation (VE)

VE = Respiratory Rate x Tidal Volume

Alveolar Minute Ventilation (VA)

VA = (Tidal Volume – Deadspace) x Respiratory Rate

Airway Resistance (Raw)

Raw = (PIP – Plateau pressure) / Flow

Mean Airway Pressure (Paw)

Paw = ((Inspiratory Time x Frequency) / 60) x (PIP – PEEP) +PEEP

Work of Breathing (WOB)

WOB = Change in Pressure x Change in Volume

Alveolar-Arterial Oxygen Tension Gradient (P(A-a)O2)

P(A-a)O2 = PAO2 – PaO2

Alveolar Oxygen Tension (PAO2)

PAO2 = (PB – PH2O) x FiO2 – (PaCO2 / 0.8)

Arterial/Alveolar Oxygen Tension (a/A) Ratio

(a/A) Ratio = PaO2/PAO2

Arterial Oxygen Content (CaO2)

CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)

End-Capillary Oxygen Content (CcO2)

5
CcO2 = (Hb x 1.34 x SaO2) + (PAO2 x 0.003)

Mixed Venous Oxygen Content (CvO2)

CvO2 = (Hb x 1.34 x SvO2) + (PvO2 x 0.003)

Shunt Equation (QS/QT)

QS/QT = (CcO2 – CaO2) / (CcO2 – CvO2)

Modified Shunt Equation (QS/QT)

QS/QT = ((PAO2 – PaO2) x 0.003) / ((CaO2 – CvO2) + (PAO2 – PaO2) x 0.003)

Arterial-Mixed Venous Oxygen Content Difference (C(a-v)O2)

C(a-v)O2 = CaO2 – CvO2

Oxygen-to-Air Entrainment Ratio (O2:Air)

O2:Air = 1 : (100 – FiO2) / (FiO2 – 2)

Arterial Oxygen Saturation Estimation (SaO2)

SaO2 = PaO2 + 30

PaO2/FiO2 Ratio (P/F Ratio)

P/F Ratio = PaO2 / FiO2

Oxygenation Index (OI)

OI = ((Paw x FiO2) / PaO2) x 100

Oxygen Consumption (VO2)

VO2 = Cardiac Output x C(a-v)O2

Oxygen Extraction Ratio (O2ER)

O2ER = (CaO2 – CvO2) / CaO2

FiO2 Estimation for Nasal Cannula

FiO2 = 20 + (4 x Liter Flow)

6
Oxygen Cylinder Duration
Duration = (Gauge Pressure x Tank Factor) / Liter Flow

Liquid Oxygen System Duration

Duration = (344 x Liquid Weight) / Flow

Cardiac Index (CI)

CI = Cardiac Output / Body Surface Area

Cardiac Output (QT)

QT = Heart Rate x Stroke Volume

Cardiac Output (CO) Fick’s Method

CO = (O2 Consumption / CaO2 – CvO2)

Cerebral Perfusion Pressure (CPP)

CPP = Mean Arterial Pressure – Intracranial Pressure

Mean Arterial Pressure (MAP)

MAP = (Systolic BP + (2 x Diastolic BP)) / 3

Stroke Volume (SV)

SV = Cardiac Output / Heart Rate

Maximum Heart Rate (HRmax)

HRmax = 220 – Age

Heart Rate on an EKG Strip (HR)

HR = 300 / # of large boxes between R waves

Respiratory Quotient (RQ)

RQ = VCO2 / VO2

Systemic Vascular Resistance (SVR)

SVR = (MAP – CVP) x (80 / Cardiac Output)

7
Pulmonary Vascular Resistance (PVR)
PVR = (MPAP – PCWP) x (80 / Cardiac Output)

Static Compliance (Cst)

Cst = Tidal Volume / (Plateau Pressure – PEEP)

Dynamic Compliance (Cdyn)

Cdyn = Tidal Volume / (Peak Pressure – PEEP)

Deadspace to Tidal Volume Ratio (VD/VT)

(VD/VT) = (PaCO2 – PECO2) / PaCO2

Children Dosage Estimation

Child Dose = (Age / Age + 12) x Adult Dose

Infant Dosage Estimation

Infant Dose = (Age in Months / 150) x Adult Dose

Anion Gap
Anion gap = Na+ – (Cl- + HCO3-)

Body Surface Area (BSA)

BSA = ((4 x Body Weight) + 7) / (Body Weight + 90)

Elastance
Elastance = Change in Pressure / Change in Volume

Smoking Use Calculation (Pack Years)

Pack Years = (Packs Smoked per Day) x (Number of Years Smoked)

Suction Catheter Size Estimation

Catheter Size = (Internal Diameter / 2) x 3

Endotracheal Tube Size Estimation in Children

Tube Size = (Age + 16) / 4

8
Boyle’s Law
P1 x V1 = P2 x V2

Charles’ Law
V 1 / T1 = V 2 / T2

Gay-Lussac’s Law
P1/T1 = P2/T2

LaPlace’s Law
P = (2 x Surface Tension) / Radius

Celsius to Fahrenheit Temperature Conversion

˚F = (˚C x 1.8) + 32

Fahrenheit Celsius Temperature Conversion

˚C = (˚F – 32) x 1.8

Celsius to Kelvins Temperature Conversion

K = ˚C + 273

Helium/Oxygen Conversion (He/O2)

Actual Flow = Given Flow Rate x Factor

Total Lung Capacity (TLC)

TLC = IRV + VT + ERV + RV
TLC = VC + RV
TLC = IC + FRC

Vital Capacity (VC)

VC = IRV + VT + ERV
VC = IC + ERV
VC = TLC – RV

Inspiratory Capacity (IC)

9
IC = IRV + VT
IC = TLC – FRC
IC = VC – ERV

Functional Residual Capacity (FRC)

FRC = ERV + RV
FRC = TLC – IC

Time Constant (t)

t = Compliance x Resistance

Ideal Body Weight (IBW)

IBW = 50 kg + (2 x Number of Inches over 5 feet)

Tidal Volume (VT)

VT = Flow Rate x Inspiratory Time

Exhaled Tidal Volume (VT)

VT = Minute Ventilation / Frequency

Corrected Tidal Volume (VT)

VT = Expired Tidal Volume – Tube Volume

Pressure Support Ventilator Setting (PSV)

PSV = ((Peak Pressure – Plateau Pressure) / Set Flow) x Peak Flow

Rapid Shallow Breathing Index (RSBI)

RSBI = Rate / Tidal Volume

Endotracheal Tube Size Estimation in Children

Tube Size = (Age + 16) / 4

Minimum Flow Rate in Mechanical Ventilation

Flow Rate = Minute Ventilation x I:E Ratio Sum of Parts

10
Respiratory Calculations

Now that you know the formulas, that means it’s time for us to put
them to use. In this section, we’re going to walk you through an
example problem for each of the equations that you need to know
as a Respiratory Therapy Student.

For these practice problems, as long as you know the formula, the
math is very simple. All you have to do is just plug the numbers in.

So if you’re ready, let’s go ahead and get started. J

11
Minute Ventilation (VE)
A patient has the following bedside spirometry results:
• Respiratory Rate = 12
• Tidal volume = 450 mL
• Dead Space = 147 mL
• Vital Capacity = 1.2 L

Based on this data, what is the patient’s minute ventilation?

Formula:
VE = Respiratory Rate x Tidal Volume

VE = 12 x 450

VE = 5,400 mL/min

Divide by 1,000 to convert mL to L.

VE = 5.4 L/min

12
Alveolar Minute Ventilation (VA)
A patient has the following bedside spirometry results:
• Rate = 12
• Tidal Volume = 450 mL
• Dead Space = 147 mL
• Vital Capacity = 1.2 L

Based on this data, what is the patient’s minute ventilation?

Formula:
VA = (Tidal Volume – Deadspace) x Respiratory Rate

VA = (Tidal Volume – Deadspace) x Respiratory Rate

VA = (450 – 147) x 12

VA = 3,636 mL/min

Divide by 1,000 to convert mL to L.

VA = 3.6 L/min

13
Airway Resistance (Raw)
An adult patient that is receiving mechanical ventilation has a PIP
of 30 cm H2O and a plateau pressure of 10 cm H2O with a set flow
rate of 60 L/min. What is the airway resistance?

Formula:
Raw = (PIP – Plateau pressure) / Flow

Raw = (PIP – Plateau pressure) / Flow

Raw = (30 – 10) / 1

Raw = 20 cm H2O/L/sec

14
Mean Airway Pressure (Paw)
The following data was obtained on a 63-year-old female patient
who is receiving ventilatory support:
• Rate = 12/min
• Tidal Volume = 450 mL
• Inspiratory Time = 1.3 seconds
• PIP = 25
• PEEP = 5

Calculate the mean airway pressure:

Formula:
Paw = ((Inspiratory Time x Frequency) / 60) x (PIP – PEEP) +PEEP

Paw = ((1.3 x 12) / 60) x (25 – 5) + 5

Paw = ((15.6) / 60) x (25 – 5) + 5

Paw = 0.26 x (25 – 5) + 5

Paw = 5.2 + 5

Paw = 10.2 cmH2O

15
Work of Breathing (WOB)
An adult patient is intubated and receiving mechanical
ventilation. Given the following data, calculate the work of
breathing:

• ∆P = 6.9 cmH2O
• ∆V = 0.8 L

Formula:
WOB = Change in Pressure x Change in Volume

WOB = 6.9 x 0.8

WOB = 5.5 cmH2O/L

16
Alveolar-Arterial Oxygen Tension Gradient (P(A-
a)O2)
The following data was obtained on an adult patient:
• PaO2 = 87 mmHg
• PAO2 = 107 mmHg

What is the alveolar-arterial oxygen tension gradient?

Formula:
P(A-a)O2 = PAO2 – PaO2

P(A-a)O2 = 107 – 87

P(A-a)O2 = 20 mmHg

17
Alveolar Oxygen Tension (PAO2)
The following data was obtained on an adult patient:
• FiO2 = 50%
• PaCO2 = 35 mmHg
• PB = 760 mmHg
• PH2O = 47 mmHg

What is the PAO2?

Formula:
PAO2 = (PB – PH2O) x FiO2 – (PaCO2 / 0.8)

PAO2 = (760 – 47) x 0.40 – (35 / 0.8)

PAO2 = (713 x 0.40) – 43.75

PAO2 = 241.5 mmHg

18
Arterial/Alveolar Oxygen Tension (a/A) Ratio
A patient has a PaO2 of 108 mmHg and a PAO2 of 300 mmHg.
What is the arterial/alveolar oxygen tension ratio?

Formula:
(a/A) Ratio = PaO2/PAO2

(a/A) Ratio = 108 / 300

(a/A) Ratio = 0.36 mmHg

(a/A) Ratio = 35%

19
Arterial Oxygen Content (CaO2)
An adult patient has a PaO2 of 95 mmHg, an oxygen saturation of
96%, and a hemoglobin of 13 g/dL. What is the arterial oxygen
content?

Formula:
CaO2 = (Hb x 1.34 x SaO2) + (PaO2 x 0.003)

CaO2 = (13 x 1.34 x 0.96) + (95 x 0.003)

CaO2 = 16.72 + 0.285

CaO2 = 17 vol%

20
End-Capillary Oxygen Content (CcO2)
An adult patient has a PAO2 of 88 mm Hg, an oxygen saturation of
94%, and a hemoglobin of 16 g/dL. What is the end-capillary
oxygen content?

Formula:
CcO2 = (Hb x 1.34 x SaO2) + (PAO2 x 0.003)

CcO2 = (16 x 1.34 x 0.94) + (88 x 0.003)

CcO2 = 20.15 + 0.264

CcO2 = 20.4 vol%

21
Mixed Venous Oxygen Content (CvO2)
An adult patient has a PvO2 of 38 mm Hg, a mixed venous
saturation of 74%, and a hemoglobin of 14 g/dL. What is the mixed
venous oxygen content?

Formula:
CvO2 = (Hb x 1.34 x SvO2) + (PvO2 x 0.003)

CvO2 = (14 x 1.34 x 0.74) + (38 x 0.003)

CvO2 = 13.88 + 0.114

CvO2 = 14 vol%

22
Shunt Equation (QS/QT)
The following data was provided for an adult patient:
• CcO2 = 20.8 vol%
• CaO2 = 19.3 vol%
• CvO2 = 13.9 vol%
Calculate the physiologic shunt percentage for this patient.

Formula:
QS/QT = (CcO2 – CaO2) / (CcO2 – CvO2)

QS/QT = (20.8 – 19.3) / (20.8 – 13.9)

QS/QT = 1.5 / 6.9

QS/QT = 0.22

Multiply by 100 to convert to a percentage.

QS/QT = 22 %

23
Modified Shunt Equation (QS/QT)
The following data was provided for an adult patient:
• PaO2 = 155 mmHg
• PAO2 = 650 mmHg
• CaO2 = 19.9 vol%
• CvO2 = 13.2 vol%

Calculate the shunt percentage for this patient.

Formula:
QS/QT = ((PAO2 – PaO2) x 0.003) / ((CaO2 – CvO2) + (PAO2 – PaO2) x 0.003)

QS/QT = ((650 – 155) x 0.003)) / ((19.9 – 13.2) + (650 – 155) x 0.003)

QS/QT = 1.49 / 6.7 + 495 x 0.003

QS/QT = 1.49 / 8.19

QS/QT = 0.18

Multiply by 100 to convert to a percentage.

QS/QT = 18%

24
Arterial-Mixed Venous Oxygen Content Difference
(C(a-v)O2)
An adult patient in the ICU has a CaO2 of 19.2 vol% and a CvO2 of
14.7 vol%. Calculate the Arterial-Mixed Venous Oxygen Content
Difference:

Formula:
C(a-v)O2 = CaO2 – CvO2

C(a-v)O2 = 19.2 – 14.7

C(a-v)O2 = 4.5 vol%

25
Oxygen-to-Air Entrainment Ratio (O2:Air)
What is the air-to-oxygen entrainment ratio of 60%?

Formula:
O2:Air = 1 : (100 – FiO2) / (FiO2 – 2)

O2:Air = 1 : (100 – 60) / (60 – 2)

O2:Air = 1 : (40 / 58)

O2:Air = 1 : 0.7

26
Arterial Oxygen Saturation Estimation (SaO2)
An adult patient has a PaO2 of 63 mmHg. What is the estimated
SaO2?

Formula:
SaO2 = PaO2 + 30

Estimated SaO2 = 63 + 30

Estimated SaO2 = 93 mmHg

27
PaO2/FiO2 Ratio (P/F Ratio)
An adult patient who is receiving oxygen at an FiO2 of 40% has a
PaO2 of 88 mmHg. What is the PaO2/FiO2 ratio?

Formula:
P/F Ratio = PaO2 / FiO2

P/F Ratio = 88 / 0.4

P/F Ratio = 220 mmHg

28
Oxygenation Index (OI)
The following data was obtained on an adult patient:
• FiO2 = 40%
• PaO2 = 80 mmHg
• Mean Airway Pressure = 9.8 cmH2O

What is the oxygenation index?

Formula:
OI = ((Paw x FiO2) / PaO2) x 100

OI = ((9.8 x 0.4) / 80) x 100

OI = (3.92 / 80) x 100

OI = 0.049 x 100

OI = 4.9

29
Oxygen Consumption (VO2)
What is the total oxygen consumption of an adult patient with the
following data:
• Cardiac Output = 6.2 L/min
• C(a-v)O2 = 5 vol%

Formula:
VO2 = Cardiac Output x C(a-v)O2

VO2 = 6.2 x 0.05

VO2 = 0.31 L/min

Multiply by 1,000 to convert mL to L.

VO2 = 310 mL/min

30
Oxygen Extraction Ratio (O2ER)
An adult patient has an arterial oxygen content of 18 vol% and a
mixed venous oxygen content of 13 vol% . What is the oxygen
extraction ratio?

Formula:
O2ER = (CaO2 – CvO2) / CaO2

O2ER = (18 – 13) / 18

O2ER = 0.2778

O2ER = 27.8 vol%

31
FiO2 Estimation for Nasal Cannula
An adult patient receiving oxygen therapy via nasal cannula at 4
L/min. What is the estimated FiO2?

Formula:
FiO2 = 20 + (4 x Liter Flow)

FiO2 = 20 + (4 x 4)

FiO2 = 20 + 16

FiO2 = 36%

32
Oxygen Cylinder Duration
A patient is receiving oxygen via nasal cannula at 2 L/min from a
size E tank with 2,200 psig. How long will the tank deliver oxygen?

Everything you need to perform the calculation is given in the

question except for the tank factors.

Cylinder Tank Factors:

• D Cylinder = 0.16
• E Cylinder = 0.28
• G Cylinder = 2.41
• H Cylinder = 3.14
• M Cylinder = 1.56

For this question, the patient is using an E cylinder which means

that you will use a tank factor of 0.28 for the equation.

Now all you have to do is plug the numbers in.

Formula:
Duration = (Gauge Pressure x Tank Factor) / Liter Flow

Duration = (2,200 x 0.28) / 2

Duration = 616 / 2

Duration = 308 minutes

Divide by 60 to convert minutes to hours.

Duration = 5 hours and 8 minutes

33
Liquid Oxygen System Duration
A liquid oxygen system with a weight of 3 lbs is being used and
the patient is receiving oxygen via nasal cannula with a flow of 2
L/min. How long will the liquid oxygen system last?

Formula:
Duration = (344 x Liquid Weight) / Flow

Duration = (344 x 3) / 2

Duration = 1,032 / 2

Duration = 516 minutes

Divide by 60 to convert minutes to hours.

Duration = 8 hours and 36 minutes

34
Cardiac Index (CI)
A 59-year-old female patient has a cardiac output of 5 L/min and a
body surface area of 2.7 m2. What is the cardiac index?

Formula:
CI = Cardiac Output / Body Surface Area

CI = 5 / 2.7

CI = 1.85 L/min/m2

35
Cardiac Output (QT)
A 57-year-old male patient has a heart rate of 94 beats/min and a
stroke volume of 44 mL/beat. What is the cardiac outlook?

Formula:
QT = Heart Rate x Stroke Volume

QT = 94 x 44

QT = 4,136 mL/min

QT = 4.1 L/min

36
Cardiac Output (CO) Fick’s Method
The following data was obtained on an adult patient:
• Body Surface Area = 1.7 m2
• CaO2 = 21 vol%
• CvO2 = 16 vol%

Calculate the cardiac output using Fick’s method:

Formula:
CO = (O2 Consumption / CaO2 – CvO2)

First, you need to calculate the O2 Consumption multiply the Body

Surface Area by 130.

O2 Consumption = 130 x 1.7

O2 Consumption = 221

Now, just plug the rest of the numbers into the formula.

CO = (221 / 21 – 16)

CO = (221 / 0.05)

CO = 4,420 mL/min

Divide by 1,000 to convert mL to L.

CO = 4.42 L/min

37
Cerebral Perfusion Pressure (CPP)
An adult patient has an MAP of 88 mmHg and an ICP of 15 mmHg.
Calculate the cerebral perfusion pressure:

Formula:
CPP = Mean Arterial Pressure – Intracranial Pressure

CPP = 88 mmHg – 15 mmHg

CPP = 73 mmHg

38
Mean Arterial Pressure (MAP)
An adult patient has a blood pressure measurement of 130/90
mmHg. What is the mean arterial pressure?

Formula:
MAP = (Systolic BP + (2 x Diastolic BP)) / 3

MAP = (130 + (2 x 90)) / 3

MAP = 310 / 3

MAP = 103.3 mmHg

39
Stroke Volume (SV)
A 58-year-old female patient has a heart rate of 92/min and a
cardiac output of 6 L/min. What is her stroke volume?

Formula:
SV = Cardiac Output / Heart Rate

SV = 6 / 92

SV = 0.065 L

Multiply by 1,000 to convert to mL.

SV = 65 mL

40
Maximum Heart Rate (HRmax)
What is the maximum heart rate of a 44-year-old female patient?

Formula:
HRmax = 220 – Age

HRmax = 220 – 44

HRmax = 176 beats/min

41
Heart Rate on an EKG Strip (HR)
An adult patient has the following EKG strip:

What is the patient’s heart rate?

Formula:
HR = 300 / # of large boxes between R waves

There are 3 large boxes between the R waves on the EKG strip.

HR = 300 / 3

HR = 100 beats/min

42
Systemic Vascular Resistance (SVR)
An adult patient has the following measurements:
• Cardiac Output = 4.0 L/min
• Central Venous Pressure = 9 mmHg
• Mean Arterial Pressure = 75 mmHg

What is the calculated Systemic Vascular Resistance?

Formula:
SVR = (MAP – CVP) x (80 / Cardiac Output)

SVR = (75 – 9) x (80 / 4)

SVR = 66 x 20

SVR = 1,320 dynes/sec/cm5

43
Pulmonary Vascular Resistance (PVR)
An adult patient has the following measurements:
• Cardiac Output = 5.0 L/min
• Mean Pulmonary Artery Pressure = 23 mmHg
• Pulmonary Capillary Wedge Pressure = 7 mmHg

What is the calculated Pulmonary Vascular Resistance?

Formula:
PVR = (MPAP – PCWP) x (80 / Cardiac Output)

PVR = (23 – 7) x (80 / 5)

PVR = 16 x 16

PVR = 256 dynes/sec/cm5

44
Static Compliance (Cst)
An adult patient who is receiving mechanical ventilation has a
tidal volume of 450 mL, peak pressure of 30 cmH2O, plateau
pressure of 22 cmH2O, and a PEEP of 5. What is the static
compliance?

Formula:
Cst = Tidal Volume / (Plateau Pressure – PEEP)

Cst = 450 / (22 – 5)

Cst = 26.5 mL/cmH2O

45
Dynamic Compliance (Cdyn)
An adult patient who is receiving mechanical ventilation has a
tidal volume of 450 mL, peak pressure of 30 cmH2O, plateau
pressure of 22 cmH2O, and a PEEP of 5. What is the static
compliance?

Formula:
Cdyn = Tidal Volume / (Peak Pressure – PEEP)

Cdyn = 450 / (30 – 5)

Cdyn = 18 mL/cmH2O

46
Deadspace to Tidal Volume Ratio (VD/VT)
An adult patient has a PaCO2 of 44 mmHg and a PECO2 of 34
mmHg. What is the deadspace to tidal volume ratio?

Formula:
(VD/VT) = (PaCO2 – PECO2) / PaCO2

(VD/VT) = (44 – 34) / 44

(VD/VT) = 10 / 44

(VD/VT) = 23%

47
Children Dosage Estimation
What would be to appropriate dose for a 9-year-old boy when the
adult dose is 44 mg?

Formula:
Child Dose = (Age / Age + 12) x Adult Dose

Child Dose = (9 / (9 + 12)) x 44

Child Dose = (9 / (9 + 12)) x 44

Child Dose = 0.429 x 44

Child Dose = 18.9 mg

48
Infant Dosage Estimation
What would be to appropriate dose for a 13-month-old infant
when the adult dose is 37 mg?

Formula:
Infant Dose = (Age in Months / 150) x Adult Dose

Infant Dose = (13 / 150) x 37

Infant Dose = 0.087 x 37

Infant Dose = 3.2 mg

49
Anion Gap
A patient has the following data:
• Na+ = 144 mEq/L
• Cl- = 104 mEq/L
• HCO3 = 24 mEq/L

Calculate the anion gap:

Formula:
Anion Gap = Na+ – (Cl- + HCO3-)

Anion Gap = 144 – (104 + 24)

Anion Gap = 16 mEq/L

50
Body Surface Area (BSA)
What is the body surface areas of an adult female patient who
weighs 153 lbs?

First, you must convert pounds to kilograms.

153 lbs / 2.2 = 69.5 kg

Formula:
BSA = ((4 x Body Weight) + 7) / (Body Weight + 90)

BSA = ((4 x 69.5) + 7) / (69.5 + 90)

BSA = 1.74 m2

51
Elastance
An adult patient is intubated and receiving mechanical
ventilation. Given the following data, calculate the elastance:
• ∆P = 6 cmH2O
• ∆V = 0.7 L

Formula:
Elastance = Change in Pressure / Change in Volume

Elastance = 6 / 0.7

Elastance = 8.6 cmH2O/L

52
Smoking Use Calculation (Pack Years)
A 54-year-old male patient has been smoking 2 packs of
cigarettes per day for 27 years. Her smoking history would be
recorded as:

Formula:
Pack Years = (Packs Smoked per Day) x (Number of Years Smoked)

Pack Years = 2 x 27

Pack Years = 54

53
Suction Catheter Size Estimation
A 62-year-old male patient with retained secretions is intubated
with a size 8 endotracheal tube. What size catheter would you
recommend for suctioning this patient?

Formula:
Catheter Size = (Internal Diameter / 2) x 3

Catheter Size = (8 / 2) x 3

Catheter Size = 12 Fr

54
Endotracheal Tube Size Estimation in Children
Intubation is indicated for a 4-year-old child in the emergency
department. What size tube would you select?

Formula:
Tube Size = (Age + 16) / 4

Tube Size = (4 + 16) / 4

Tube Size = 5.0 mm

55
Celsius to Fahrenheit Temperature Conversion
A temperature of 30 ˚C is what temperature in Fahrenheit?

Formula:
˚F = (˚C x 1.8) + 32

˚F = (30 x 1.8) + 32

˚F = 86

56
Fahrenheit Celsius Temperature Conversion
A temperature of 69 ˚F is what temperature in Celsius?

Formula:
˚C = (˚F – 32) x 1.8

˚C = (69 – 32) x 1.8

˚C = 66.6

57
Celsius to Kelvins Temperature Conversion
A temperature of 33 ˚C is what temperature in Kelvins?

Formula:
K = ˚C + 273

K = 33 + 273

K = 306

58
Helium/Oxygen Conversion (He/O2)
A patient is receiving a 70%Helium/30%Oxygen is running that is
running on a flow rate of 8 L/min. What is the actual flow rate of
this He/O2 gas mixture?

To complete this calculation, you must remember the Heliox

factors:
• 80/20% Mixture = 1.8
• 70/30% Mixture = 1.6

Formula:
Actual Flow = Given Flow Rate x Factor

For this patient, the question tells you that they are receiving a
70/30% mixtures, which means that you must use 1.6 as the factor
within the equation.

Actual Flow = 8 x 1.6

Actual Flow = 12.8 L/min

59
Vital Capacity (VC)
After performing pulmonary function tests on an adult patient,
the following results were obtained:
• Tidal Volume = 600 mL
• Inspiratory Reserve Volume = 3,000 mL
• Expiratory Reserve Volume = 1,300 mL
• Residual Volume = 1,100 mL
• Vital Capacity = 4,900 mL

What is the vital capacity?

Formulas:
VC = IRV + VT + ERV
VC = IC + ERV
VC = TLC – RV

VC = 3,000 + 600 mL + 1,300

VC = 4,900 mL

60
Inspiratory Capacity (IC)
After performing pulmonary function tests on an adult patient,
the following results were obtained:
• Tidal Volume = 600 mL
• Inspiratory Reserve Volume = 3,000 mL
• Expiratory Reserve Volume = 1,300 mL
• Residual Volume = 1,100 mL
• Vital Capacity = 4,900 mL

What is the inspiratory capacity?

Formulas:
IC = IRV + VT
IC = TLC – FRC
IC = VC – ERV

IC = 3,000 + 600

IC = 3,600 mL

61
Functional Residual Capacity (FRC)
After performing pulmonary function tests on an adult patient,
the following results were obtained:
• Tidal Volume = 600 mL
• Inspiratory Reserve Volume = 3,000 mL
• Expiratory Reserve Volume = 1,300 mL
• Residual Volume = 1,100 mL
• Vital Capacity = 4,900 mL

What is the functional residual capacity?

Formulas:
FRC = ERV + RV
FRC = TLC – IC

FRC = 1,300 + 1,100

FRC = 3,300 mL

62
Total Lung Capacity (TLC)
After performing pulmonary function tests on an adult patient,
the following results were obtained:
• Tidal Volume = 600 mL
• Inspiratory Reserve Volume = 3,000 mL
• Expiratory Reserve Volume = 1,300 mL
• Residual Volume = 1,100 mL
• Vital Capacity = 4,900 mL

What is the total lung capacity?

Formulas:
TLC = IRV + VT + ERV + RV
TLC = VC + RV
TLC = IC + FRC

TLC = 3,000 + 600 + 1,300 + 1,100

TLC = 6,000 mL

63
Time Constant (t)
A 63-year-old male patient who is receiving ventilatory support
has a compliance of 0.09 L/cmH2O and a total resistance of 4
cmH2O/L/sec. Calculate the time constant:

Formula:
t = Compliance x Resistance

t = 0.09 x 4

t = 0.36 seconds

64
Ideal Body Weight (IBW)
A 61-year-old female patient is receiving positive pressure
ventilatory support. The patient’s height is 5’7”. What is her ideal
body weight?

Formula:
IBW = 50 kg + (2 x Number of Inches over 5 feet)

IBW = 50 + (2 x 7)

IBW = 50 + 14

IBW = 64 kg

65
Tidal Volume (VT)
An adult patient who is intubated and receiving ventilatory
support has a flow rate of 7 L/min and an inspiratory time of 0.7
seconds. What is the tidal volume?

Formula:
VT = Flow Rate x Inspiratory Time

First, you need to convert the flow rate from L/min to mL/sec.

7 L/min = 7,000 mL/60 seconds

7,000 / 60 = 116.7 mL/sec

Now just plug the numbers in.

VT = 116.7 x 0.7

VT = 8.2 mL

66
Exhaled Tidal Volume (VT)
An adult patient who is receiving mechanical ventilation displays
the following data:
• Rate = 12/min
• Minute Ventilation = 7.2 L/min

What is the exhaled tidal volume?

Formula:
VT = Minute Ventilation / Frequency

VT = 7.2 / 12
VT = 0.6 L

Multiply by 1,000 to convert L to mL.

VT = 600 mL

67
Corrected Tidal Volume (VT)
The following data was obtained on an adult patient who is
receiving mechanical ventilation:
• Expired tidal volume = 600 mL
• PIP = 30 cmH2O
• PEEP 5 cmH2O
• Tubing compression factor = 3 mL/cmH2O

What is the corrected tidal volume?

First, you need to calculate the tube volume.

Tube Volume = Pressure Change x 3 mL/cmH2O

Tube Volume = (30 – 5) x 3

Tube Volume = 75 mL

Formula:
VT = Expired Tidal Volume – Tube Volume

VT = 600 – 75

VT = 525 mL

68
Pressure Support Ventilator Setting (PSV)
An intubated patient is receiving mechanical ventilation in the
SIMV mode with the following settings:
• VT = 400 mL
• Rate = 12 breaths/min
• PIP = 40 cm H2O
• Pplat = 20 cm H2O
• Inspiratory flow = 60 L/min or (1 L/sec)

The patient is breathing spontaneously with a spontaneous rate of

12 breaths/min and a spontaneous peak inspiratory flow of 30
L/min (0.5 L/sec). What is the level of PSV that is needed to
overcome the imposed work of breathing?

Formula:
PSV = ((Peak Pressure – Plateau Pressure) / Set Flow) x Peak Flow

PSV = ((Peak Pressure – Plateau Pressure) / Set Flow) x Peak Flow

PSV = ((40 – 20) / 1) x 0.5

PSV = 10 cmH2O

69
Rapid Shallow Breathing Index (RSBI)
An adult patient who is on the ventilator has a rate of 16/min and a
tidal volume of 500 mL. What is the rapid shallow breathing
index?

Formula:
RSBI = Rate / Tidal Volume

RSBI = 16 / 500

RSBI = 8,000 breaths/min/mL

Divide by 100 to convert to breaths/min/L.

RSBI = 80 breaths/min/L

70
Endotracheal Tube Size Estimation in Children
A 6-year-old boy needs to be intubated in the emergency
department. What size ET tube would you recommend?

Formula:
Tube Size = (Age + 16) / 4

Tube Size = (6 + 16) / 4

Tube Size = 5.5

Always round up to the next biggest size.

Tube Size = 6 mm

71
Minimum Flow Rate in Mechanical Ventilation
An adult patient is receiving mechanical ventilation with the
following settings:
• Tidal Volume = 550 mL
• Rate = 12/min
• I:E ratio = 1:3

What is the required minimum flow rate?

First, you need to calculate the Minute Ventilation.

VE = Rate x Tidal Volume

VE = 12 x 550 mL

VE = 6,600 mL

You can convert mL to L by dividing by 1,000.

VE = 6.6 L

Now you can easily calculate the Minimum Flow Rate

Formula:
Flow Rate = Minute Ventilation x I:E Ratio Sum of Parts

Minimum Flow Rate = 6.6 x (3 + 1)

Minimum Flow Rate = 26.4 L/min

72
More Practice Questions:

In this section, we’ve provided some additional practice questions

so that you can practice and test your knowledge.

Going through practice questions is a helpful technique that you

can use to truly learn and memorize all of the equations. J

1. What is the most important calculation for the TMC Exam?

Ideal Body Weight (IBW) because it is needed to determine the
patient’s initial tidal volume setting for mechanical ventilation. You
will need to calculate a patient’s IBW multiple times on the TMC
Exam.

We break this down even further inside of our Hacking the TMC
Exam video course.

2. A patient receiving mechanical ventilation has a PIP of 60

cmH2O and a plateau pressure of 45 cmH2O. The ventilator flow
rate is set at 60 L/min. What is the patient’s airway resistance?
15 cm H2O/L/sec

3. What is the A-a gradient and why is its significant?

The A-a gradient is the alveolar arterial oxygen gradient and
represents the driving force of oxygen from the alveolar sac into
the artery.

4. What is the normal value of the A-a gradient?

The A-a gradient is normally around 10 mmHg.

5. After obtaining a patient's PFT results, they have a VC of 3.4, FRC

of 5.8, and an ERV of 1.2. What is the patient's TLC?
8.0

73
6. The physician has requested the dynamic compliance
measurement for an adult patient who is receiving mechanical
ventilation. This value can be obtained by dividing the patient’s
tidal volume by what?
(PIP – PEEP)

7. The doctor has requested the static compliance measurement

for an adult patient who is receiving mechanical ventilation. This
value can be obtained by dividing the patient’s tidal volume by
what?
(Pplat – PEEP)

8. What is a normal carbon dioxide production?

200 mL/min

9. What is the formula for alveolar partial pressure of carbon

dioxide (PACO2)?
PACO2 = VCO2 X 0.863 / VA

10. What is the formula for Deadspace/Tidal Volume Ratio?

VD/VT = (PaCO2 – PeCO2) / PaCO2

11. What is the patient’s VD/VT if their PaCO2 is 40 mmHg with a

mixed expired CO2 of 28 mm Hg?
0.3

12. What is the patient’s VD/VT if their PaCO2 is 58 mmHg with a

mixed expired CO2 of 32 mmHg?
0.45

13. What is the formula for Boyle’s Law?

P1 x V1 = P2 x V2

14. What is the formula for Charles law?

V 1 / T1 = V 2 / T2

74
15. What is the formula for Combined Gas law?
(P1 x V1 ) / T1 = (P2 x V2 ) / T2

16. An H cylinder is half full (full = 2200) and the patient is receiving
oxygen via nasal cannula at 3 L/min. How long will the cylinder last
in minutes and in hours?
1151 minutes and 19.18 hours

17. An E cylinder is at 1400 psi and the flow rate is 2.5 L/minute.
How many minutes will the tank last?
156.8 minutes

18. If a patient has smoked 2 packs of cigarettes daily for the past
35 years, what would their pack year history be?
70 pack years

19. What is the formula for Minute Ventilation?

MV = Respiratory Rate x Tidal Volume

20. A 36-year-old female patient has a respiratory rate of 12 and

tidal volume of 500 mL. What is the minute ventilation?
6 L/min

21. A 78-year-old male patient with a history of COPD has a

respiratory rate of 20 and tidal volume of 650 mL. What would his
minute volume be in Liters?
13 L/min

22. What is the formula for partial pressure?

Partial Pressure = Barometric Pressure x Fractional concentration
of Gas

23. What is the PO2 in dry air at a barometric pressure of 760

mmHg?
760 x 0.21 = 159.6

75
24. How do you calculate the PO2 of humidified air?
Partial Pressure = (Barometric Pressure – Water Vapor Pressure) x
Fractional concentration of gas

25. What is the PO2 of humidified tracheal air?

(760 – 47) x 0.21 = 149.7

26. If the alveolar gas has a PO2 of 100 mmHg, what is the PO2 of
the pulmonary capillary blood?
100 mmHg

27. In air, what is the mol percentage of Nitrogen?

78%

28. In air, what is the mol percentage of oxygen?

21%

29. In air, what is the mol percentage of Argon?

1%

30. At a normal body temperature, what is the partial pressure of

water vapor?
47 mmHg

31. PA and Pa in the alveolar gas equation represents the gas

pressures in what locations?
PA represents the gas pressure in the alveoli. Pa represents the
gas pressure in the artery.

32. In the alveolar gas equation, what does R represent?

R represents the V:Q ratio of carbon dioxide and is dependent
upon the type of metabolism that a person is undergoing.

33. What two factors determine cardiac output?

Heart Rate and Stroke volume

76
34. What is the formula for Cardiac Index?
CI= Cardiac Output / BSA

35. A Cardiac Index below what value can be life-threatening?

< 2.2

36. What is the formula for Stroke Index?

SI = Stroke Volume / BSA

37. What is the Fick Equation?

CO = VO2 / CaO2 – CvO2

38. What does the Deadspace-to-Tidal Volume Ratio measure?

It measures the percentage of the tidal volume that is dead space
which does not participate in gas exchange.

39. What is the normal value for (Vd/Vt)?

20 to 40% (or up to 60% for patients on the ventilator)

40. What is the formula to Vd/Vt?

Vd/Vt = (PaCO2 – PeCO2 / PaCO2) x 100

41. What is the average PCO2 of the exhaled air that can be
measured by a capnograph?
PeCO2

42. If you know the patient’s tidal volume but the deadspace must
be calculated, what formula should be used?
Vd/Vt x Vt

41. What is the tubing compliance when the measured volume is

100 mL and the static pressure is 65 cm H2O?
1.5 mL/cm H2O

42. While setting up a new patient on the ventilator the plateau

pressure is 47 cm H2O and the tidal volume is set at 100 mL. The

77
average PIP reached during the delivery of a breath is 28 cm H2O.
What is the amount of volume that was lost in the ventilator
tubing?
60 mL

43. What is the average tidal volume for a patient who has a
minute ventilation of 10 L/min and rate 12/min?
833 mL

44. What is inspiratory time when the tidal volume is set at 800
mL and a flow rate of 40 L/min?
1.2 seconds

45. What is the I:E ratio for a ventilator that is set to deliver a tidal
volume of 850 mL at a frequency of 15/min with a flow rate of 45
L/min?
1:2.5

46. What is the expiratory time when the rate is set to 25/min and
the inspiratory time is 0.75 seconds?
1.65 seconds

47. What flow rate would be necessary in order to deliver a tidal

volume of 600 mL with a constant waveform at a respiratory rate
of 15/min with an I:E of 1:4?
45 L/min

48. What tidal volume setting for mechanical ventilation would be

appropriate for a 5'2" female patient with normal lungs?
400 mL

49. How should the initial minute ventilation setting be adjusted

for an adult patient who has a body temperature of 40 °C?
Increase it by 30% because the minute ventilation would have to
be increased by 10% for each degree above 37° C.

78
50. What is the number of pack years for a COPD patient who has
smoked 2 packs per day for 27 years?
Pack Years = (2 x 27) = 54

51. A 52-year-old female patient has been smoking 1.5 packs of

cigarettes per day for 30 years. Her smoking history would be
recorded as:
45 pack-years

52. A patient is receiving 3 L/min of oxygen from an E-cylinder at

1200 psi. What is the approximate duration of flow?
112 minutes

53. A 5-foot, 6-inch-tall 130-lb. female patient with normal lungs

has a tidal volume of 480 mL and is breathing at a rate of 12
breaths/min. What is her alveolar ventilation?
4.20 L/min

54. A patient 43-year-old male patient is receiving volume

controlled ventilation at a rate of 12/min. The expiratory time is
3.30 seconds. What is the inspiratory time?
1.70 seconds

55. What is the formula for Work of Breathing?

WOB = Change in Pressure x Change in Volume

79
TMC Practice Questions:

As a bonus, we wanted to give you access to a few sample TMC

Practice Questions so that you can get a look and feel of how the
formulas and calculations will be used on the exam.

1. A 61-year-old male patient who weighs 165 lbs is receiving

volume control A/C ventilation with a tidal volume of 500 mL.
He has the following data:
PEEP 5
PIP 35
Pplat 30
What is the patient’s static compliance?
A. 16.7 mL/cm H2O
B. 20.0 mL/cm H2O
C. 25.7 mL/cm H2O
D. 30.0 mL/cm H2O

For the TMC Exam, you need to know how to calculate both static
and dynamic compliance. That means you should know the
formulas for both.

• Static Compliance = Exhaled VT / (Pplat – PEEP)

• Dynamic Compliance = Exhaled VT / (PIP – PEEP)

So for this one, the question asks for the patient’s static
compliance. To get the answer, all you have to do is plug the
numbers in the formula.

Static Compliance = 500 / (30 – 5)

Static Compliance = 20

The correct answer is: B. 20.0 mL/cm H2O

80
2. An adult patient with pneumonia was intubated and placed on
pressure control ventilation with an FiO2 of 40% and a PEEP of
10 cm H2O. The chest x-ray shows bilateral infiltrates. After
being on the ventilator for 30 minutes, an ABG is obtained with
the following results:
pH 7.47
PaCO2 33 torr
PaO2 60 torr
SaO2 90%
HCO3 25 mEq/L
BE +2 MEq/L
You would describe the patient’s condition as being consistent
with which of the following:
A. Mild ARDS
B. Moderate ARDS
C. Severe ARDS
D. Moderate hypoxemia

The first thing that should stand out is the fact that the PaO2 is
only 60 torr. That is very low considering the patient is getting an
FiO2 of 40% with a PEEP of 10 cm H2O.

The patient’s P/F ratio is 150 which you can calculate by dividing
the PaO2 by the FiO2. This indicates that the patient has ARDS in
the moderate form. For patients with moderate or severe ARDS,
you should recommend the initiation of the ARDSnet protocol.

So by breaking down the question, you can determine that the

correct answer has to be B.

The correct answer is: B. Moderate ARDS

3. A 63-year-old male patient is receiving mechanical ventilation

with a rate of 12/min and an l:E ratio of 1:3. What is the length of
the patient’s inspiration?

81
 A. 1.0 second
B. 1.25 seconds
C. 1.5 seconds
D. 2.0 seconds

In order to get this one correct, you needed to know how to

calculate inspiratory time.

The first step is to calculate the total cycle time by simply dividing
the 60 seconds by the rate.

60/12 = 5 seconds

Next, determine how much of the inspiratory time takes of the

total cycle time.

[1/(1+3) x 100] = 25%

Then, 25% of 5 seconds = 1.25 seconds.

The correct answer is: B. 1.25 seconds

Well, How’d You Do?

These were just a few examples to give you an idea of some of the
types of questions that you may see on the TMC Exam.

Most importantly, when it comes to Formulas and Calculations,

don’t panic!

Sure, some of the calculations are difficult, but keep in mind that
they make up a very small percentage of the exam. So you will be
just fine.

82
If you want to learn more about our strategy regarding the
equations for the exam, be sure to check out our Hacking the TMC
Exam video course.

Also, as I mentioned earlier, the more repetitions, the better. So be

sure to keep practicing with as many TMC Practice Questions as
possible. The practice questions that we provided for you here
were actually taken straight from our TMC Test Bank.

It’s one of our bestselling products where we break down

hundreds of practice questions that cover every topic you need to
know for the TMC Exam.

Each question comes with a detailed rationale that explains

exactly why the answer is correct. Thousands of students have
already used it to pass the TMC Exam.

Are you next?

If you thought the practice questions above were helpful,

definitely consider checking it out.

Click Here to Learn More

83
One More Thing!
Before you go, I just wanted to remind you about our Practice
Questions Pro membership.

As you can most likely already tell, our practice questions are
loaded with helpful tidbits of information that can help you
prepare for (and) pass the TMC Exam.

Now, you can get these TMC Practice Questions sent to your inbox
on a daily basis.

And the more practice questions you see, the better.

This way, over time, you can master every single topic that you
need to know to increase your chances of passing the exam on
your first (or next) attempt.

For many students, it’s very convenient to wake up each day and
have a new TMC Practice Question in the inbox waiting for you.

If this is something that sounds interesting to you, definitely

consider signing up.

Click Here to Get Daily Practice Questions via Email

84
Conclusion

So there you have it!

You now have access to all the formulas and calculations that you
must know, not only for Respiratory Therapy School, but for the
board exams as well.

Now it’s up to you to learn and master this information.

I definitely recommend going through each formula several times

until the information sticks. Your future self will be glad that you
did.

No worries, I have faith that you can do it!

Keep working and studying hard and you will be just fine. Thank
you so much for reading all the way to the end.

I wish you the best of luck on your journey, and as always, breathe
easy my friend. J

Copyright ã Respiratory Therapy Zone

85
References

1. AARC Clinical Practice Guidelines, (2002-2019) Respirator Care.

www.aarc.org.

2. Egan’s Fundamentals of Respiratory Care. (2010) 11th Edition.

Kacmarek, RM, Stoller, JK, Heur, AH. Elsevier.

3. Mosby’s Respiratory Care Equipment. Cairo, JM. (2014) 9th

Edition. Elsevier.

4. Pilbeam’s Mechanical Ventilation. (2012) Cairo, JM. Physiological

and Clinical Applications. 5th Edition. Saunders, Elsevier.

5. Ruppel’s Manual of Pulmonary Function Testing. (2013) Mottram,

C. 10th Edition. Elsevier.

6. Rau’s Respiratory Care Pharmacology. (2012) Gardenhire, DS. 8th

Edition. Elsevier.

7. Perinatal and Pediatric Respiratory Care. (2010) Walsh, BK,

Czervinske, MP, DiBlasi, RM. 3rd Edition. Saunders.

8. Wilkins’ Clinical Assessment in Respiratory Care (2013) Heuer, Al.

7th Edition. Saunders. Elsevier.

9. Clinical Manifestations and Assessment of Respiratory Disease.

(2010) Des Jardins, T, & Burton, GG. 6th edition. Elsevier.

10. Neonatal and Pediatric Respiratory Care. (2014) Walsh, Brian K.

4th edition. RRT. Elsevier.

11. Clinical Application of Mechanical Ventilation (2013) Chang,

David W. 4th edition. Cengage Learning.

86