Initial settings for pressure-controlled mechanical ventilation in children*

	Infant (<1 year of age)	Toddler/child (1 to 12 years)	Adolescent (>12 years)
PIP (cm H₂O)^¶	16 to 25	16 to 25	16 to 25
PEEP (cm H₂O)^¶	3 to 7	3 to 7	3 to 7
Rate (breaths/minute)	20 to 30	15 to 25	12 to 20
Inspiratory time (seconds)	0.4 to 0.6	0.7 to 0.9	0.9 to 1.2
Pressure support (cm H₂O)^Δ	Minimum 6 to 10	Minimum 6 to 10	Minimum 6 to 10
FiO₂ (%)^◊	Start with 1.0, rapidly wean to ≤0.6	Start with 1.0, rapidly wean to ≤0.6	Start with 1.0, rapidly wean to ≤0.6
Flow trigger (L/minute)	0.25 to 0.5	0.8 to 2	0.8 to 2
Pressure support cycle	10 to 25% of peak flow rate	10 to 25% of peak flow rate	10 to 25% of peak flow rate

PIP: peak inspiratory pressure; PEEP: positive end-expiratory pressure; FiO₂: fraction of inspired oxygen.
* Consultation with an expert in the mechanical ventilation of children (eg, pediatric intensivist or pediatric anesthesiologist) is strongly encouraged. Regardless of ventilator settings employed, the physician must assess ventilator settings shortly after initiation and frequently thereafter and adjust them as needed to meet oxygenation and ventilation goals as the natural course of the underlying pathophysiology evolves.
¶ Initial pressure settings can be established based upon pressures identified during manual ventilation with a bag and a manometer/standalone respiratory mechanics monitor prior to switching to the ventilator.
Δ Adjust according to endotracheal tube size: 3 to 3.5 mm: 10 cm H₂O; 4 to 4.5 mm: 8 cm H₂O; ≥5 mm: 6 cm H₂O.
◊ Wean to 0.60 or below to maintain arterial oxygen tension (PaO₂) 60 to 80, oxygen saturation (SpO₂) 92 to 97% when required PEEP is <10 cm H₂O; if required PEEP is ≥10 cm H₂O then targeted oxygen saturation may be reduced to 88 to 92% for those patients with pediatric acute respiratory distress syndrome (PARDS).

Graphic 113549 Version 2.0

خرید پکیج

Initial settings for pressure-controlled mechanical ventilation in children*