VENTILATOR SETTINGS

Question 1

VT - Tidal Volume

Answer 1

The normal volume of air displaced between normal inhalation and exhalation. Usually 500ml.

Ventilator specific: volume delivered/taken per breath. May be a set rate or variable.

Question 2

RR/f

Answer 2

Respiratory rate OR Frequency: the number of breaths taken per minute

Question 3

FiO2

Answer 3

Fraction of inspired oxygen: the oxygen concentration being delivered to the pt

• Room air is 21%
• Ventilator settings are anywhere between 25 - 100%

Question 4

PEEP

Answer 4

Positive end-expiratory pressure: pressure applied to airways at end-expiration. PEEP helps to open collapsed alveoli to improve ventilation.

• It is generated by airflow and resistance
• helps to increase FRC, oxygen saturation, recruitment, and lung compliance
• PEEP of 5 = physiological PEEP
• Settings: between 8 and 20

Question 5

Ve - Minute Ventilation

Answer 5

Ve = amount of air delivered per minute. It is directly related to CO2 clearance.
Ve = VT (tidal volume) x RR
Goal: 5 - 10 L/Min

Question 6

Pinsp/PIP - Peak Inspiratory Pressure

Answer 6

The max pressure in AIRWAYS during inspiration.

Goal: <35

Question 7

Pplat - Plateau pressure

Answer 7

Indicative of lung COMPLIANCE.
- Measured at end inspiration with an inspiratory hold

Goal: <30. >30 indicates issues with compliance.

Question 8

PS - Pressure Support (SETTING)

Answer 8

When talking about SETTINGS, PS refers to the push of air given to assist patients in taking spontaneous breaths.
Goal: PS should be a minimum of 8 - 10 in order to overcome resistance of the ETT.

Question 9

SBT - Spontaneous Breathing Trial

Answer 9

A test to determine if a pt is ready to be weaned off the ventilator. Pt is placed on minimal ventilator settings for at least 30 minutes and closely observed. 
Indications: 
- normal ABG
- RSBI <105,
- Ve <15L/min
- minimal/no vasopressors
- ability to follow commands
- RR <30, VT >325
- PEEP between 5 - 8, FiO2 <50%

Question 10

RSBI - Rapid Shallow Breathing Index

Answer 10

The ratio of respirations to tidal volume - RR/VT. Increases in RR and decreases in VT = high RSBI, which means the pt has difficulty in breathing independently. This measurement is taken over one minute and is used to predict successful weaning.
Normal value: 40
Abnormal: >105

Question 11

Synchrony (needs work)

Answer 11

When the ventilator matches the pt’s respiratory effort.
If the pt is fighting the ventilator, you may need to:
- adjust settings: switch from a control to support mode
- provide analgesia/sedation
- may need neuromuscular blockage (NMB) drugs