Ventilation Strategies

A protective lung strategy is a good starting point for all ventilated patients other than those with obstructive disease (asthma/COPD). The basic premise is a low tidal volume to avoid barotrauma. Start at 6ml/kg of ideal body weight (not actual weight) and a RR of 16. Oxygen at 100% during intubation but dial back to minimum required for sats 88-95%.


Asthma and COPD require a different strategy owing to their inherent trapping of air and likelihood for volutrauma and barotrauma. They require long exhalation times so start at a RR of around 8 per minute (tolerating a degree of hypercapnia). I:E ratio of around 1:5 then keep an eye on the curves and plateau pressure and adjust as required.

Hannah Bell