Ventilator parameter

> PIP 》 > pao2, < paco2
>PEEP 》>pao2, >paco2
> rate 》<paco2
>Fio2 》 >pao2
>T¡ 》 >pao2 , > paco2

1} hypoxia & hypercapnia 》 > PIP
2} hypoxia with normal paco2 》 >Fio2
Then > T¡ or > RR or > PEEP(not>6)
without > PIP
3} hpercarbia with normoxemia
>RR 》 < PEEP 》》 < T¡


all about ventilotor😌
💥💥💥💥💥💥💥💥
✍look for co2 and PO2
if both high or low
(⬇⬇or⬆⬆)
🎈 play on peep

🗝⬆ co2 and⬆po2== decrease Peep

🗝⬇ co2 and ⬇ po2==increase peep

✍if one of them high and the other is low (or vise versa)
(⬆⬇) =
🎈play on pip
🗝⬆co2 & ⬇po2==
⬆ pip
🗝⬇ co2 &⬆po2==⬇pip

✍if po2 is normal but co2 is high or low
⬆↔️ =play on VR

🗝↔️po2⬆co2==
increase VR
🗝↔️po2 &⬇pco2==
decrease VR

🏆🏆🏆🏆🏆🏆🏆🏆
blood gas
if acidosis look for co2 & HCO3
✍BOTH ⬆⬆ & NORMAL Ph=
🎈compenated resp acidosis(if ph is still not normal so partial compensated resp)

if both⬇⬇ & ph normal ==
🎈compensated metabolic acidosis (if ph still acidotic then partial compensated metabolic)

if one ⬆ and the other is low =
🎈mixed

Ventilator parameters
FiO2. 21%———100%
PIP 10cmH20. —25cmH2O
PEEP 3cmH20 —-8 cmH20
RR. 20/min——-60/min
MAP. 10cmH2O—-12cmH2O
Ti. 0.35sec——-0.6sec
I:E. 1:1.2

Max PIP setting
<27 w 》24
27-32w 》26
33-35 w》28
Upto 25 in preterm 30 in fullterm

PEEP
as low as 3 and high as 8
Start at minimum 4-5
Inc to(6-7) if Fi02 needed >60%
May reach 8-10 if needed

Fio2
Start low at 40%
Fi02 may be Inc by (2-5) & allowing 4 max
consider Inc PEEP prior to Fi02

Rate
According to GA & Wt 50-60 if <34w or< 3 kg
40-50 if >34w or >3kg
30-40 if >40w
If rate >60 watch for air trapping
Adjust inspirstory time
Can be decreased to 20 during weaning

Ti
Start at 0.3-0.5
<1 Kg 》0.25-0.3 mim0.2
1-2 kg》0.3-0.4 mim0.2
2-3 kg 》0.35-0.55 min0.25
3-4 kg 》0.4 -0.6 Min 0.3

_________________________________
Respiratory Distress Syndrome
FiO2 0.4–0.6
Low PIP(10-20)cmH2o
Moderate PEEP 4-5
Flow rate 6-8 lit/min
Rapid rate >60/min
Ti 0.2-0.3 sec
I:E not less then1:1.2

Target Bl gas
PH : 7.25-7.35
PCO2: 45-55
Paco2: 50-70
_________________________________
Meconium Aspiration Syndrome
High PIP. 25-30
Mod PEEP 3-5
Mod rate 40-60
I:E > 1:3
If gas trapping occurs decrease PEEP and Increase exp time
Target Bl gas
PH: 7.3-7.4
PCO2: 35-45
Paco2 60-80

_________________________________
Air leak
Low PIap
Short Ti
Low PEEP
RR may be increased up to 60
High FiO2
_________________________________
Apnea
FiO2 0.21-0.3 / <25%
PIP 10-18
Low PEEP 3-4
Slow RR 30-40
Ti 0.35-0.4
Flow rate 7-8 / min
Target Bl has
PH: 7.25-7.35
Paco2 55
Pao2 50-70
__________________________________________
PPHN
Higher rate 50-75/min
PIP: 15-25
Low PEEP: 3-4
Ti 0.3-0.4
High Fio2 80-100%
__________________________________________
HIE
Rate: 30-40
PIP : 15-25
Low PEEP: 3-4
Fio2 to maintain spo2
PH 7.35 7.45
Paco2 :35-55
Pao2: 60-80
___________________________________________
Cong Diaphragmatic Hernia
Lowest PIP suffient for chest excursion
relatively rapid rate 40-80
Short Ti 0.3-0.5
PH: >7.25
Paco2 45-65
Pao2 50-70
__________________________________________
BPD
Lowest required PIP 10-20
Mod PEEP 4-5
Slow rate 20-40
To 0.4-0.7
PH 7.25-7.35
Paco2 50+
Pao2 50-70
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