Template:Lung Protective Ventilator Settings Peds
Lung Protective Mechanical Ventilation for Pediatric Patients
Lung Protective Ventilator Settings[1] 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[2][3]
- Mode
- Volume-assist control
- Tidal Volume
- Start 6-8cc/kg predicted body weight[4]
- 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)[5]
- Start 6-8cc/kg predicted body weight[4]
- 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 at normal rate for age (see chart)
- Maintain pH = 7.30-7.45
- FiO2/PEEP (titrate for oxygenation)
- Move in tandem to achieve:
- SpO2 BETWEEN 88-95%
- PaO2 BETWEEN 55-80