guidelines to adjusting ventilator settings

So you're tired of doctors just making up ventilator changes. Here are the recommended AARC guidelines for adjusting ventilator settings. Study these, and impress a doctor or a nurse with your wisdom:

1. PaCo2 greater than 45 (or EtCo2 greater than 50)

• Increase RR
• Increase VT

2. PaCo2 less than 35 (or EtCO2 less than 30)

• Decrease Rate
• Decrease VT

3. PO2 less than 60 (or SpO2 less than 90%)

• Increase FiO2 to 60%
• Increase PEEP
  
• Increase FiO2 to 100%

4. SpO2 greater than 95% (or appropriate oxygenation for patient)

• Reduce FiO2 to 60%
• Reduce PEEP to 5
  

This is to act as a guideline only to assist you in making the appropriate ventilator changes based on invasive ABG results and/ noninvasive EtCO2 and SpO2 monitoring. Of course you'll need to know your patient.

For a great review of EtCO2 monitoring check out this post.

For a printable cheat sheet with this information and more, click here.

For a printable cheat sheet for EtCO2 monitoring click here.