Expert Ventilator Management for Critical Care
Mobile-optimized comprehensive guide for ventilator settings and patient care protocols
Ventilator Settings Calculator
Recommended Settings
Enter patient data and select conditions to calculate recommended ventilator settings.
Oxygen Duration Calculator
Oxygen Supply Duration
Enter oxygen parameters to calculate estimated duration.
Ventilator Modes Overview
Volume Control (VCV)
Delivers a set tidal volume regardless of airway pressure
- Indications: Most general ICU patients
- Advantages: Guaranteed minute ventilation
- Disadvantages: Risk of barotrauma
Pressure Control (PCV)
Delivers breaths at a set pressure, allowing tidal volume to vary
- Indications: ARDS, variable lung compliance
- Advantages: Reduced barotrauma risk
- Disadvantages: Variable minute ventilation
Pressure Support (PSV)
Patient triggered breaths with pressure assist
- Indications: Weaning, spontaneous breathing
- Advantages: Patient comfort, work of breathing
- Disadvantages: Requires patient effort
SIMV
Mandatory breaths at set intervals + spontaneous breaths
- Indications: Weaning process
- Advantages: Gradual transition to spontaneous
- Disadvantages: Patient dyssynchrony possible
CPAP
Continuous Positive Airway Pressure - constant pressure throughout respiratory cycle
- Indications: Mild hypoxemia, post-extubation support
- Advantages: Simple, preserves airway defenses
- Disadvantages: Limited ventilatory assistance
BiPAP
Bilevel Positive Airway Pressure - two pressure levels (IPAP/EPAP)
- Indications: Hypercapnia, moderate respiratory failure
- Advantages: Assists with oxygenation and ventilation
- Disadvantages: More complex, potential for gastric insufflation
Ventilator Settings Guide
Basic Ventilator Parameters
Tidal Volume (Vt)
6-8 mL/kg ideal body weight (ARDS: 4-6 mL/kg)
Respiratory Rate (RR)
12-20 bpm (adjust based on pH/CO2)
Fraction of Inspired Oxygen (FiO2)
Start 100%, titrate to SpO2 88-95%
PEEP
5 cmH2O (ARDS: 10-15 cmH2O)
Advanced Ventilator Parameters
Inspiratory Pressure
Limit < 30-35 cmH2O to prevent barotrauma
Inspiratory Time
0.8-1.2 seconds (I:E ratio 1:2 to 1:4)
Flow Pattern
Square flow for VCV, decelerating for PCV
Trigger Sensitivity
-1 to -2 cmH2O or 1-2 L/min flow trigger
Monitoring Parameters
Arterial Blood Gas
pH 7.35-7.45, PaCO2 35-45 mmHg, PaO2 >60 mmHg
Ventilator Graphics
Pressure, flow, and volume waveforms for troubleshooting
Dynamic Compliance
Assesses lung mechanics (C = Vt/(Pplat - PEEP))
AutoPEEP
Detect intrinsic PEEP in obstructive lung disease
Patient Care Protocols
Sedation Management
- Goal: Adequate sedation without oversedation
- Assess daily: Pain, Agitation, Delirium (PAD)
- Target RASS -1 to 0 when possible
- Implement spontaneous breathing trials
Weaning Protocol
- Assess readiness: RSBI <105
- Spontaneous breathing trial duration: 30-120 minutes
- Criteria for extubation: Successful SBT + resolution of cause
- Post-extubation care: Humidified oxygen, suction availability
Infection Control
- Elevate HOB 30-45 degrees
- Oral care every 2-4 hours
- ETT cuff pressure 20-25 cmH2O
- Ventilator circuit changes only when visibly soiled