COVID-19
Ventilator Management
Recommendations for management of vented patients in ICU
Lung protective ventilation
- Initial mode of ventilation: Assist control PRVC
- Tidal volume: 6 mL/kg Predicted Body Weight (calculate this from height and gender)
- Male patients: 50 + 2.3 [height (inches) – 60]
- Female patients: 45.5 + 2.3 [height (inches) – 60]
- PEEP 10 cm H2O: Monitor hemodynamics with increasing PEEP
- Respiratory rate: 20-25
- Consider patients’ pre-intubation respiratory rate
- Goal: Limit over-distention of alveoli and ensure adequate oxygenation and ventilation. Over-distention causes inflammation, organ dysfunction, decreased venous return, and worsens ARDS.
Source:
American Heart Association: Oxygenation and Ventilation of COVID-19 Patients Module 4: Ventilation Management
Last Updated 8 months ago
Oxygenation
- PaO2 >60 / SpO2 88-98%
- FIO2 to maintain a SpO2 of 88-98%
- FIO2 <0.6
- Try to avoid 100% oxygen, which favors de-nitrogenation atelectasis
- Lower FIO2 of 0.7-0.9 may not drastically change oxygenation due to high levels of shunt
Ventilation
- Tidal volumes of 4-8 mL/kg of PBW
- pH 7.25-7.42
- PaCO2 40-65 / end-tidal carbon dioxide (ETCO2) 35-60 mm Hg
Sources:
American Heart Association: Oxygenation and Ventilation of COVID-19 Patients Module 4: Ventilation Management
Last Updated 8 months ago
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Lung protective ventilation
- Initial mode of ventilation: Assist control PRVC
- Tidal volume: 6 mL/kg Predicted Body Weight (calculate this from height and gender)
- Male patients: 50 + 2.3 [height (inches) – 60]
- Female patients: 45.5 + 2.3 [height (inches) – 60]
- PEEP 10 cm H2O: Monitor hemodynamics with increasing PEEP
- Respiratory rate: 20-25
- Consider patients’ pre-intubation respiratory rate
- Goal: Limit over-distention of alveoli and ensure adequate oxygenation and ventilation. Over-distention causes inflammation, organ dysfunction, decreased venous return, and worsens ARDS.
Source:
American Heart Association: Oxygenation and Ventilation of COVID-19 Patients Module 4: Ventilation Management
Last Updated 8 months agoOxygenation
- PaO2 >60 / SpO2 88-98%
- FIO2 to maintain a SpO2 of 88-98%
- FIO2 <0.6
- Try to avoid 100% oxygen, which favors de-nitrogenation atelectasis
- Lower FIO2 of 0.7-0.9 may not drastically change oxygenation due to high levels of shunt
Ventilation
- Tidal volumes of 4-8 mL/kg of PBW
- pH 7.25-7.42
- PaCO2 40-65 / end-tidal carbon dioxide (ETCO2) 35-60 mm Hg
Sources:
American Heart Association: Oxygenation and Ventilation of COVID-19 Patients Module 4: Ventilation Management
Last Updated 8 months ago