Mechanical Ventilation: A Primer
Nick Mohr, MD (nicholas-mohr@uiowa.edu)
February 2014
1. Terminology
a. PEEP
b. Tidal Volume
c. FiO2
d. Respiratory Rate
i. Set
ii. Actual
e. Peak Pressure
f.
Plateau Pressure
2. Ventilator Settings
a. Oxygenation
b. Ventilation
c. Lung Protection
3. Ventilation Algorithm – Lung Protective Ventilation
a. Calculate ideal tidal volume (ideal body weight)
b. Select respiratory rate
c. Select oxygenation parameters
i. Role of PEEP
ii. What is shunt?
d. Limit plateau pressure
e. Check blood gas, reassess
f.
Definition of lung protective ventilation
i. Tidal volume
ii. Plateau pressure
iii. PEEP
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iv. FiO2
v. pH
vi. Blood pressure
vii. Comfort, sedation, pain control
4. What is the problem in obstructive lung disease?
a. How do I recognize it?
5. Ventilation Algorithm – Obstructive lung disease
a. Calculate ideal tidal volume (ideal body weight)
b. Select respiratory rate
c. Select oxygenation parameters
i. Role of PEEP
ii. What is shunt?
d. Limit plateau pressure
e. Check blood gas, reassess
6. Troubleshooting the ventilator
a. Hypoxia
i. D
ii. O
iii. P
iv. E
b. Hypotension
i. Post-induction
ii. New onset (later)
c. Summary
7. Modes of Ventilation
a. Volume Control
b. Pressure Control
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c. Synchronized Intermittent Mandatory Ventilation
d. Pressure Support
e. Pressure-Regulated Volume Control
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