A 5'10" male patient with normal lungs has been intubated and requires mechanical ventilation with volume-controlled continuous mandatory ventilation (VC-CMV)
The tidal volume and ventilator rate settings that should be recommended for this patient are which of the following?
a. VT = 525 mL, rate = 14 breaths/min
b. VT = 750 mL, rate = 12 breaths/min
c. VT = 825 mL, rate = 10 breaths/min
d. VT = 950 mL, rate = 8 breaths/min
ANS: A
First calculate ideal body weight (IBW) for a male, which is 106 + 6(ht – 60) = 75 kg. Then using the range of 5-7 mL/kg IBW, the tidal volume range for this patient is 375-525 mL. Minute ven-tilation is about 100 mL/kg IBW. Therefore, minute ventilation should be approximately 7.5 L/min. Dividing the calculated minute ventilation by the tidal volume range for this patient pro-vides a range of rates for the tidal volumes: 14-20 breaths/min depending on the set volumes. The most appropriate volume and rate combination for this patient is 525 mL ? 14 breaths/min = 7.35 L/min.
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