Title: Ventilatory Support in Resource-limited Settings<br/>Author: Michael Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p> <strong><u>Mechanical Ventilation for Septic Patients in Resource-Limited Settings</u></strong></p> <ul> <li> An international team of physicians just published a series of recommendations for ventilatory support of septic patients in resource-limited settings.</li> <li> Pearls from these recommendations include: <ul> <li> Elevate the head of the bed to 30<sup>o</sup> - 45<sup>o</sup></li> <li> Consider tidal volumes of 5 - 7 ml/kg PBW in all patients</li> <li> Use minimum levels of PEEP ( 5 cm H<sub>2</sub>O) in all patients with sepsis and acute respiratory failure (unless the patient has moderate to severe ARDS)</li> <li> Lower F<sub>i</sub>O<sub>2</sub> to target SpO<sub>2</sub> > 88% or PaO<sub>2</sub> > 60 mm Hg</li> <li> Use lung ultrasound to evaluate pulmonary edema when CXR is not available</li> <li> Consider using SpO<sub>2</sub> to FiO<sub>2 </sub>(S/F) as an alternative to P/F when blood gas analyzers are not available</li> </ul> </li> </ul> <fieldset><legend>References</legend>
<p> Neto AS, Schultz MJ, Festic E. Ventilatory support of patients with sepsis or septic shock in resource-limited settings. <em>Intensive Care Med</em> 2016:42:100-3.</p> </fieldset>