Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Table 3

Recommended initial lung protective mechanical ventilator settings following intubation in patients without ALI/ARDS.

	Patients without risk factors for ALI/ARDS	Patients with risk factors for ALI/ARDS*
VT (mL/kg PBW)	<10	6–8
Respiratory rate (breath/min)	≥15	≥20
PEEP (cm H2O)	≥5	≥8
FiO2 (%)	<60**	<60**
Target SpO2 (%)^†	92–96	92–96
Humidification device	HME***	HME***

*Major risk factors for acquired ALI/ARDS include: Sepsis, trauma, blood transfusions, cardiopulmonary bypass, and others.
**The lowest FiO₂ to achieve an acceptable SpO₂ should be used.
***The heterogeneity of the HME should be known, and, if severe respiratory acidosis occurs, heated humidifiers should be used instead [68].
^†If FiO₂ requirements are above 60%, a target SpO₂ of 88–92% should be tolerated [63].
VT: tidal volume, PBW: predicted body weight, and HME: heat and moisture exchangers.