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 30^o - 45^o
  • 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 F_iO₂ 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.