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Fio2 Peep TV RR 12 6 +5 50%: PH Pco Pao Hco

This document describes volume assist/control ventilation mode. It delivers a set tidal volume with each breath, whether patient or machine triggered. The variables that can be set include respiratory rate, tidal volume, PEEP, FiO2, inspiratory flow rate, and flow pattern. This mode ensures a minimum minute ventilation and is a good general purpose mode for lung protective ventilation. When using this mode, peak and plateau pressures need to be monitored, as well as minute ventilation to avoid alkalemia from excessive triggering. Initial settings typically start with a respiratory rate matching pre-intubation minute ventilation, a tidal volume of 8 cc/kg PBW, and high PEEP and FiO2 weaned to maintain oxygenation goals

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sunil Agarwal
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125 views1 page

Fio2 Peep TV RR 12 6 +5 50%: PH Pco Pao Hco

This document describes volume assist/control ventilation mode. It delivers a set tidal volume with each breath, whether patient or machine triggered. The variables that can be set include respiratory rate, tidal volume, PEEP, FiO2, inspiratory flow rate, and flow pattern. This mode ensures a minimum minute ventilation and is a good general purpose mode for lung protective ventilation. When using this mode, peak and plateau pressures need to be monitored, as well as minute ventilation to avoid alkalemia from excessive triggering. Initial settings typically start with a respiratory rate matching pre-intubation minute ventilation, a tidal volume of 8 cc/kg PBW, and high PEEP and FiO2 weaned to maintain oxygenation goals

Uploaded by

sunil Agarwal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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VOLUME ASSIST/CONTROL VENTILATION by Nick Mark MD ONE onepagericu.

com Link to the


most current
@nickmmark version →
How does this mode work?
• Delivers a set volume of air with each breath; patient triggered
breaths are identical to machine triggered breaths
• Time and patient triggered, volume cycled, volume limited mode

Pressure
What are the variables I set?
• RR – respiratory rate
• TV – tidal volume (better to express in terms of cc/kg PWB than ccs)
• PEEP – positive end expiratory pressure (typically at least +5)
• FiO2 – fraction of inhaled oxygen (typically at least 30%)

Flow
• V – (“v dot) inspiratory flow rate (typically 30-60 lpm) Decerating
pattern breaths
• Flow pattern – is the flow constant (e.g. takes longer
square wave) or decelerating (‘decel’)
Decel may be more comfortable but Patient
it prolongs the inspiratory phase

Volume
triggered
breath
When should I use this mode?
• Ensures that a patient receives a minimum MV
• This is a good general-purpose mode; good for providing Inhalation Exhalation I E
Lung Protective Ventilation (LPV)
• PRVC may have lower peak pressures; pressure modes
may be more comfortable for select patients
ABG: pH / PCO2 / PaO2 / HCO3
What do I need to monitor? Advanced settings
• Need to make sure the peak pressure and plateau
VENTILATION OXYGENATION I:E RATIO TRIGGER
pressure do not exceed safe limits.
→ If Pplat is too high decrease the Tv
• You will also need to monitor MV. If the patient is
triggering excessively (or auto-triggering), they can
SETTINGS: RR Tv PEEP FiO2 𝑽̇ Flow Pattern
become alkalemic.
Choosing Initial settings EXAMPLE: bpm 12 cc/kg 6 +5 50% 40lpm Square wave Flow
• RR - Try to match the persons initial minute ventilation by Decelerating Pressure
selecting a rate to match their pre-intubation MV needs. If you want to increase If you want to increase If you want to decrease Flow trigger is
• TV - Use 8cc/kg PBW and adjust as needed. For patients the pH ! increase the the PaO2 or SpO2 Inhalation time (increase may be more

v1.0 (2020-04-09)
with ARDS (or at high risk) consider starting at 6cc/kg PBW. minute ventilation increase the FiO2 and the I:E ration) ! increase sensitive that
(MV) by changing the PEEP the inspiratory flow rate pressure; adjust
• Start with low PEEP and high FiO2 and wean to maintain to limit
RR and TV (V) and use square wave
SpO2 goal (typically > 90%). flow pattern autotriggering

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