CCMCP Ventilation - Mechanical - Head injury

Question 1

CCMCP Ventilation - Mechanical - Brain injury - Initial ventilator parameters?

Answer 1

Mode - VC or PRVC
Rate - 16
VT - 8 ml/kg
FiO2 - 1.0
PEEP - 5 cm H20
I:E - 1:2

Question 2

CCMCP Ventilation - Mechanical - Brain injury - Which parameter is to be adjusted to meet CO2 goals?

Answer 2

Rate

Question 3

CCMCP Ventilation - Mechanical - Brain injury - CO2 Goals?

Answer 3

PaCO2 of 35-40 mmHg
PvCO2 of 42 mmHg or greater
EtCO2 of 33 mmHg or less

Question 4

CCMCP Ventilation - Mechanical - Brain injury - ETCO2 > 33 mmHg?

Answer 4

Increased RR by 2 until ETCO2 33 or less

Question 5

CCMCP Ventilation - Mechanical - Brain injury - Signs of herniation?

Answer 5

Consult TP to consider hyperventilation

Question 6

CCMCP Ventilation - Mechanical - Brain injury - Hyperventilation CO2 Goals?

Answer 6

PaCO2 of 32 – 35 mmHg
PvCO2 of 37 mmHg or greater
EtCO2 of 30 mmHg or less

Question 7

CCMCP Ventilation - Mechanical - Brain injury - PvCO2 < 42 mmHg?

Answer 7

Decrease rate by 2 breaths until PvCO2 42 mmHg or greater

Question 8

CCMCP Ventilation - Mechanical - Brain injury - FiO2 titration?

Answer 8

Decreased by 10% q 5 min to maintain SpO2 of 94-97%