The safe range of ventilation for this patient is 315-420ml and the respective tidal volumes for 6, 7, and 8 ml/kg are 315, 365 and 420 ml respectively. Therefore, the safe range of ventilation is 490-660ml (6-8ml/kg) and the respective tidal volumes for 6,7,8 ml/kg are 490, 575 and 660 ml respectively. Tidal volume of 8ml/kg = 82.2 kg x 8 ml/kg Tidal volume of 7ml/kg = 82.2 kg x 7 ml/kg Tidal volume of 6ml/kg = 82.2 kg x 6 ml/kg Remember, the safe range for tidal volumes is 6-8 ml/kg. We have already learned how to calculate IBW (steps 1 and 2), so let’s try step 3 using the IBWs that were calculated earlier in this chapter. Note: you will always round your result up or down to match the settings on the ventilator (usually, they use whole numbers only and count by 5s). The best way to determine your ideal weight is to speak with a doctor or nutritionist. It does not consider gender or frame size These formulas cannot account for all individual differences, but they provide a good estimate of what is ideal for a person of your height. Multiply your 6, 7 and 8 ml/kg and write these in your chart, so you have a handy reference point for the tidal volumes you can use now and in the future. Only uses height to calculate ideal body weight.Use appropriate IBW formula (male versus female) to calculate your IBW.Determine your patient’s height and sex.Let’s review the steps to determine a safe tidal volume for your patients. Once the IBW is calculated, it is multiplied by 6 and then 8 to get the range of safe tidal volumes for a patient on a mechanical ventilator. Today, 8 ml/kg is the hard limit for tidal volumes to be set by clinicians in control modes. This discovery revolutionized tidal volume strategies and has become the gold standard of adult tidal volume ranges to decrease the risk of VILI from volutrauma/barotrauma. Using the equation, a 5-foot, 4-inch tall woman would have an ideal weight of 120 pounds: IBW 100 + (4 x 5) 120. If you're under 5 feet tall, subtract 2 pounds for each inch under 5 feet. The results were conclusive that using tidal volumes of 6-8 ml/kg of ideal body weight directly improved morbidity and mortality. For women, the ideal body weight calculation starts with 100 pounds for the first 5 feet of height, then you add 5 pounds for each additional inch. Researchers also studied patients diagnosed with ARDS to see if the amount of tidal volume impacted morbidity and mortality. In the early 2000s, many studies were done to find the best tidal volume range based on ideal body weight to decrease the risk of VILI and ARDS. This approach still resulted in volutrauma and VILI. Even with the determination of using the ideal body weight instead of actual body weight, historically, tidal volumes of 10 ml for every kilogram of IBW were often used.
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