Words and phrasesThese are some of the words and phrases commonly used in pediatric respiratory care:
Ventilator settings
Vt - tidal volume - the size of the volume of the breath. Set 10 - 15 cc/kg
RR - rate - the number of breaths per minute. Set 10 - 20 or per patient
PIP - peak inspiratory pressure - the highest pressure created on inspiration. Set per
chest rise and CO2.
PEEP - positive end expiratory pressure. To increase FRC and help improve
oxygenation. set 3 - 5 cm H2O
FIO2 - fraction of inspired oxygen - the percentage of oxygen from 21% ( room air ) -
100% ( the maximum ).
PS - pressure support - an extra pressure on inspiration to overcome resistance of the
endotracheal tube. Helps simulate normal respiration.
Adjusting blood gases with ventilator settings
Respiratory acidosis: CO2 greater than 45
RR - increasing the rate will help decrease the CO2.
PIP - increasing the PIP will give a larger breath and help decrease the CO2.
Vt - increasing the Vt will give a larger breath to help decrease the CO2.*** as the CO2 is decreased the pH will increase to assist in resolving the acidosis.
Respiratory alkalosis: CO2 less than 35
RR - decreasing the rate will increase the CO2.
PIP - decreasing the PIP will give a smaller breath and help increase the CO2.
Vt - decreasing the Vt will give a smaller breath and help increase the CO2.*** as the CO2 is increased, the pH will decrease to assist in resolving the alkalosis.
Low PaO2: below 60
PEEP - increasing the PEEP will decrease FRC and keep the alveoli open to improve
oxygenation. Cardiac output should be monitored because an increase in PEEP
can decrease cardiac output.
PIP - increasing the PIP can indirectly improve oxygenation with extra pressures.
Vt - increasing Vt can indirectly improve oxygenation, also.