Mechanical Ventilation for Septic Patients in Resource-Limited Settings
An international team of physicians just published a series of recommendations for ventilatory support of septic patients in resource-limited settings.
Pearls from these recommendations include:
Elevate the head of the bed to 30o - 45o
Consider tidal volumes of 5 - 7 ml/kg PBW in all patients
Use minimum levels of PEEP ( 5 cm H2O) in all patients with sepsis and acute respiratory failure (unless the patient has moderate to severe ARDS)
Lower FiO2 to target SpO2 > 88% or PaO2 > 60 mm Hg
Use lung ultrasound to evaluate pulmonary edema when CXR is not available
Consider using SpO2 to FiO2 (S/F) as an alternative to P/F when blood gas analyzers are not available
References
Neto AS, Schultz MJ, Festic E. Ventilatory support of patients with sepsis or septic shock in resource-limited settings. Intensive Care Med 2016:42:100-3.
