A 5'2" female patient with normal lungs has been intubated and requires mechanical ventilation with volume-controlled continuous mandatory ventilation (VC-CMV)
The tidal volume (VT) and ventilator rate settings that should be recommended for this patient are which of the following?
a. VT = 315 mL, rate = 20 breaths/min
b. VT = 364 mL, rate = 14 breaths/min
c. VT = 468 mL, rate = 12 breaths/min
d. VT = 563 mL, rate = 10 breaths/min
ANS: B
First calculate ideal body weight (IBW) for a female, which is 105 + 5(ht – 60) = 52 kg. Then using the range of 5-7 mL/kg IBW the tidal volume range for this patient is 260-364 mL. Minute ventilation is about 100 mL/kg IBW. Therefore, minute ventilation should be approximately 5.2 L/min. Then dividing the calculated minute ventilation by the tidal volume range for this patient provides 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 364 mL ? 14 breaths/min = 5.1 L/min.
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