How to Survive the ICU - Ventilator User Interface
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Rules for ventilator settings:

1. The physician decides the ventilator settings.
2. Respiratory therapists place patient on ventilator.
3. An ABG is checked once ventilator is in place.
4. Ventilator settings are adjusted to meet these goals:
- Pa 02 60-90 mm Hg
- Pa C02 40 mm Hg, patient normal baseline
- pH 7.35-7.45
- Inspiratory pressure < 35 cm H20
- Minimized work of breathing
Image Click on photo for an enlarged view and explanation of ventilator components
Ventilator User Interface and Settings
Mode: The way a breath is delivered.
  Assist Control: A/C
  Intermittent Mandatory Ventilation: IMV
  Synchronized Intermittent Ventilation: SIMV
  Pressure Support Ventilation: PSV
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Rate: (f tot)
Usually set at 10 - 15 breaths per minute.
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Tidal Volume: (Vte)
10 - 12 ml/kg which is roughly 800 ml per breath in a 70 kg person.
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Fi02: Fraction of Inspired Oxygen.
 Started at 100% usually & weaned down to 40% once ABG is normalized.
  21% Oxygen-Room Air is mixed with 100% Oxygen to achieve 80-60-40%

Goal: To get a Pa02 of 60-90 mmHg on an
Fi02 of 40-60%. (0.4-0.6)
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Positive End Expiratory Pressure:
Start 2.5 cm H20, maximum. 10 cm H20 Prevent collapse of small airways & alveoli at end expiration.
When is it indicated?
  In highly hypoxemic patients. (ARDS)
  When we want to decrease Fi02 to avoid
oxygen toxicity.
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Copyright © 2004, University of California San Diego, School of Medicine