Template:Lung Protective Ventilator Settings Peds - Revision history

Rossdonaldson1 at 21:24, 2 July 2020

2020-07-02T21:24:55Z

← Older revision		Revision as of 21:24, 2 July 2020
Line 7:		Line 7:
	#*Start 6-8cc/kg [[ideal body weight estimation\|predicted body weight]]<ref>Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.</ref>		#*Start 6-8cc/kg [[ideal body weight estimation\|predicted body weight]]<ref>Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.</ref>
	#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.		#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.
	#*Target a peak pressure of < 30-35 cmH2O (see figure 1) and/or a plateau pressure < 28 cmH2O (i.e. titrate down)		#*Target a peak pressure of < 30-35 cmH2O (see figure 1) and/or a plateau pressure < 28 cmH2O (i.e. titrate down)<ref>Kneyber et.al. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC). Intensive Care Med. 2017 Dec;43(12):1764-178.</ref>
	#Inspiratory Flow Rate (comfort)		#Inspiratory Flow Rate (comfort)
	#*More comfortable if higher rather than lower		#*More comfortable if higher rather than lower

Rossdonaldson1: /* Lung Protective Mechanical Ventilation for Pediatric Patients */

2020-07-02T21:24:13Z

Lung Protective Mechanical Ventilation for Pediatric Patients

← Older revision		Revision as of 21:24, 2 July 2020
Line 7:		Line 7:
	#*Start 6-8cc/kg [[ideal body weight estimation\|predicted body weight]]<ref>Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.</ref>		#*Start 6-8cc/kg [[ideal body weight estimation\|predicted body weight]]<ref>Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.</ref>
	#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.		#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.
	#*~~Titrate down if~~ peak pressure >30 ~~mmHg~~		#*Target a peak pressure of < 30-35 cmH2O (see figure 1) and/or a plateau pressure < 28 cmH2O (i.e. titrate down)
	#Inspiratory Flow Rate (comfort)		#Inspiratory Flow Rate (comfort)
	#*More comfortable if higher rather than lower		#*More comfortable if higher rather than lower

Rossdonaldson1: /* Lung Protective Mechanical Ventilation for Pediatric Patients */

2020-07-02T21:22:23Z

Lung Protective Mechanical Ventilation for Pediatric Patients

← Older revision		Revision as of 21:22, 2 July 2020
Line 13:		Line 13:
	#'''Respiratory Rate (titrate for ventilation)'''		#'''Respiratory Rate (titrate for ventilation)'''
	#*Average patient on ventilator requires 120mL/kg/min for eucapnia		#*Average patient on ventilator requires 120mL/kg/min for eucapnia
	#*Start ~~16-18 breaths/min~~		#*Start at normal rate for age (see chart)
	#*Maintain pH = 7.30-7.45		#*Maintain pH = 7.30-7.45
	#'''FiO2/PEEP (titrate for oxygenation)'''		#'''FiO2/PEEP (titrate for oxygenation)'''

Rossdonaldson1: /* Lung Protective Mechanical Ventilation for Pediatric Patients */

2020-07-02T21:21:02Z

Lung Protective Mechanical Ventilation for Pediatric Patients

← Older revision		Revision as of 21:21, 2 July 2020
Line 1:		Line 1:
	===Lung Protective [[Initial mechanical ventilation settings (peds)\|Mechanical Ventilation for Pediatric Patients]]===		===Lung Protective [[Initial mechanical ventilation settings (peds)\|Mechanical Ventilation for Pediatric Patients]]===
	''[[~~Initial_mechanical_ventilation_settings#Lung_Protective_Strategy~~\|Lung Protective Ventilator Settings]]<ref>[[EBQ:ARDSnet\|The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342(18):1301-1308.]] </ref> should be the default for all intubated patients, unless contraindicated. It has demonstrated mortality benefit for [[ARDS]]-like pulmonary conditions; limits barotrauma and decreases complications of high FiO2<ref>[[EBQ:ARDSnet\|ARDSnet]] </ref><ref>O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.</ref>''		''[[Initial mechanical ventilation settings (peds)\|Lung Protective Ventilator Settings]]<ref>[[EBQ:ARDSnet\|The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342(18):1301-1308.]] </ref> should be the default for all intubated patients, unless contraindicated. It has demonstrated mortality benefit for [[ARDS]]-like pulmonary conditions; limits barotrauma and decreases complications of high FiO2<ref>[[EBQ:ARDSnet\|ARDSnet]] </ref><ref>O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.</ref>''

	#'''Mode'''		#'''Mode'''

Rossdonaldson1: /* Lung Protective Mechanical Ventilation */

2020-07-02T21:20:32Z

Lung Protective Mechanical Ventilation

← Older revision		Revision as of 21:20, 2 July 2020
Line 1:		Line 1:
	===Lung Protective [[Mechanical Ventilation]]===		===Lung Protective [[Initial mechanical ventilation settings (peds)\|Mechanical Ventilation for Pediatric Patients]]===
	''[[Initial_mechanical_ventilation_settings#Lung_Protective_Strategy\|Lung Protective Ventilator Settings]]<ref>[[EBQ:ARDSnet\|The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342(18):1301-1308.]] </ref> should be the default for all intubated patients, unless contraindicated. It has demonstrated mortality benefit for [[ARDS]]-like pulmonary conditions; limits barotrauma and decreases complications of high FiO2<ref>[[EBQ:ARDSnet\|ARDSnet]] </ref><ref>O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.</ref>''		''[[Initial_mechanical_ventilation_settings#Lung_Protective_Strategy\|Lung Protective Ventilator Settings]]<ref>[[EBQ:ARDSnet\|The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342(18):1301-1308.]] </ref> should be the default for all intubated patients, unless contraindicated. It has demonstrated mortality benefit for [[ARDS]]-like pulmonary conditions; limits barotrauma and decreases complications of high FiO2<ref>[[EBQ:ARDSnet\|ARDSnet]] </ref><ref>O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.</ref>''

Rossdonaldson1: Created page with "===Lung Protective Mechanical Ventilation=== ''Lung Protective Ventilator SettingsEBQ:ARDSnet|T..."

2020-07-02T21:19:42Z

Created page with "===Lung Protective Mechanical Ventilation=== ''Lung Protective Ventilator Settings<ref>EBQ:ARDSnet|T..."

New page

===Lung Protective [[Mechanical Ventilation]]===
''[[Initial_mechanical_ventilation_settings#Lung_Protective_Strategy|Lung Protective Ventilator Settings]]<ref>[[EBQ:ARDSnet|The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342(18):1301-1308.]] </ref> should be the default for all intubated patients, unless contraindicated. It has demonstrated mortality benefit for [[ARDS]]-like pulmonary conditions; limits barotrauma and decreases complications of high FiO2<ref>[[EBQ:ARDSnet|ARDSnet]] </ref><ref>O'Brien J. Absorption Atelectasis: Incidence and Clinical Implications. AANA Journal. June 2013. Vol. 81, No. 3.</ref>''

#'''Mode'''
#*Volume-assist control
#'''Tidal Volume'''
#*Start 6-8cc/kg [[ideal body weight estimation|predicted body weight]]<ref>Brower RG, et al. "Ventilation With Lower Tidal Volumes As Compared With Traditional Tidal Volumes For Acute Lung Injury And The Acute Respiratory Distress Syndrome". The New England Journal of Medicine. 2000. 342(18):1301-1308.</ref>
#**Predicted/"ideal" body weight is used because a person's lung parenchyma does not increase in size as the person gains more weight.
#*Titrate down if peak pressure >30 mmHg
#Inspiratory Flow Rate (comfort)
#*More comfortable if higher rather than lower
#*Start at 60-80 LPM
#'''Respiratory Rate (titrate for ventilation)'''
#*Average patient on ventilator requires 120mL/kg/min for eucapnia
#*Start 16-18 breaths/min
#*Maintain pH = 7.30-7.45
#'''FiO2/PEEP (titrate for oxygenation)'''
#*Move in tandem to achieve:
#*SpO2 BETWEEN 88-95%
#*PaO2 BETWEEN 55-80