Version July 2025
| Initial ventilator settings | ||||||||
| Calculate PBW | ||||||||
| Male = | 50 + 2.3 [height (inches) – 60] or | |||||||
| 50 + 0.91 [height (cm) – 152.4] | ||||||||
| Female = | 45.5 + 2.3 [height (inches) – 60] or | |||||||
| 45.5 + 0.91 [height (cm) – 152.4] | ||||||||
| Set mode to volume assist-control | ||||||||
| Set initial tidal volume to 6 mL/kg PBW | ||||||||
| Set initial ventilator rate ≤35 breaths/minute to match baseline minute ventilation (to avoid hypercapnia) | ||||||||
| Subsequent tidal volume adjustment | ||||||||
| Pplat goal: ≤30 cm H2O | ||||||||
| Check inspiratory Pplat with 0.5 second inspiratory pause at least every 4 hours and after each change in PEEP or tidal volume. | ||||||||
| If Pplat >30 cm H2O, decrease tidal volume in 1 mL/kg PBW steps to 5 or if necessary to 4 mL/kg PBW. | ||||||||
| If Pplat <25 cm H2O and tidal volume <6 mL/kg, increase tidal volume by 1 mL/kg PBW until Pplat >25 cm H2O or tidal volume = 6 mL/kg. | ||||||||
| If breath stacking (autoPEEP) or severe dyspnea occurs, tidal volume may be increased to 7 or 8 mL/kg PBW if Pplat remains ≤30 cm H2O. | ||||||||
| Arterial oxygenation and PEEP | ||||||||
| Oxygenation goal: PaO2 55 to 80 mmHg or SpO2 88 to 95% | ||||||||
| Use these FiO2/PEEP combinations to achieve oxygenation goal: | ||||||||
| FiO2 | 0.3 | 0.4 | 0.5 | 0.6 | 0.7 | 0.8 | 0.9 | 1 |
| PEEP | 5 | 5 to 8 | 8 to 10 | 10 | 10 to 14 | 14 | 14 to 18 | 18 to 24 |
| PEEP should be applied starting with the minimum value for a given FiO2. | ||||||||
