ventilation stratigies for ARDS includes low tidal volume, high peep, target plateau pressure of 30

related: ARDS, ICU
tags: #icu

Notes

Ventilation strategies for ARDS includes PEEP, tidal volume, and plateau pressure.

Use low tidal volume, use 4 to 8 cc/kg ideal body weight. Target 6 cc/kg
- make sure to measure patients as females under report their height and males overreport
Target plateau pressure < 30 cm H2O
Use PEEP table

Using high PEEP and initial 6 cc/kg tidal volume can cause elevated plateau pressure. If plateau pressure is above 30 with initial setting, first check to make sure there is no ventilator desynchrony that could be minimized by increasing sedation. Next decrease tidal volume to 5 and then 4 cc/kg. Decreasing TV can cause more respiratory acidosis that could be offset by increasing respiratory rate or sodium bicarb.