The NIH Adult Respiratory Distress Syndrome (ARDS) Network developed a ventilator strategy using a lower tidal volume. Adjustments may be necessary if acidosis or alkalosis occur.
ventilator mode: volume assist/control
consider increasing tidal volume (inspiratory plateau pressure may be > 30 cm H2O); increase respiratory rate as for 7.15 to 7.29 (next)
7.15 to 7.29
increase respiratory rate; if pH does not correct and the maximum respiratory rate has been reached then consider infusion of bicarbonate
7.30 to 7.45
no adjustments needed
if the patient is not triggering the ventilator, decrease the respiratory rate
maximum respiratory rate: 35 breaths per minute
minimum respiratory rate: 6 breaths per minute
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