PULMONARY CRITICAL CARE
Ventilator Command Pro
Lung Protective Ventilation (LPV) & Hemodynamic HUD
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Lung Protective Ventilation (LPV) Standards
In the management of Acute Respiratory Distress Syndrome (ARDS), lung protective ventilation is the clinical gold standard. The goal is to minimize Ventilator-Induced Lung Injury (VILI) by adhering to specific physiological targets based on the patient's Predicted Body Weight (PBW).
Key Safety Thresholds
- Tidal Volume: Aim for 4–8 mL/kg of PBW.
- Plateau Pressure (Pplat): Maintain < 30 cmH2O to prevent barotrauma.
- Driving Pressure: Keep < 15 cmH2O (Pplat - PEEP) to reduce mortality risk.
Clinical FAQs
Why use PBW instead of actual weight?
Lung size is determined by height and biological sex, not by adipose tissue. Using actual weight in obese patients leads to dangerously high tidal volumes and lung over-distention.
What is the significance of the P/F Ratio?
The PaO2/FiO2 ratio is the primary indicator of ARDS severity. Per the Berlin Criteria, a ratio < 300 defines ARDS, with < 100 indicating severe respiratory failure.
References
- 1. The ARDS Definition Task Force. Berlin Criteria. JAMA. 2012.
- 2. ARDSNet. Ventilation with lower tidal volumes for ALI and ARDS. N Engl J Med. 2000.
Dr. Nikhil Mahajan, PT
CLINICAL RESOURCE