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RT Equations Handout
1.) Henderson-Hasselbach Equation = Calculation of pH or PCO2
pH= 6.1 + log [ HCO3- / H2CO3]
Rule of 8’s (a rule of thumb when determining what the HCO3 will be given an pH and CO2)
pH Factor example: When pH is 7.40 and PCO2 is 40 the
7.60 8/8 PCO2 HCO3- will be?
7.50 6/8 PCO2 5/8 (40) = 25 meq/ml
7.40 5/8 PCO2
7.30 4/8 PCO2
7.20 3/8 PCO2-

2.) Alveolar Air Equation = Used to calculate the partial pressure of O2 in the alveoli, used to calculate
the A-a gradient.
PB= 760 mmhg PH20= 47 cmh20 at sea level PaCO2= from ABG (given)

PAO2= (PB-PH20) FIO2 – (PaCO2 X 1.25) or PAO2= (PB-PH20) – PaCO2/ RQ

Normal value is 100mmHg Short cut: 7(FIO2) – (PaCO2 + 10)

3.) A-a Gradient = Difference in alveolar and arterial oxygen tensions

(PAO2 – PaO2) FIO2 Must first get PAO2, PaO2 from ABG (given)

Used when estimating shunt. Remember a large A-a gradient means a large shunt. Normal is less than
10 cmH2O.

4.) Oxygen Content (CaO2)= Total amount of O2 in arterial blood, (combined and
dissolved) PaO2= from ABG (given) SaO2= from ABG (given) Hb= normal 12-15

CaO2= (PaO2 X 0.003) + (Hb X 1.36 X SaO2) Normal value is 15-24 ml/dl

5.) Predicated PaO2 based on age= Estimated value of what there PaO2 might be

PaO2= 110 – half the person’s age example: 20 year old. 110 – 10= PaO2 100

(PaO2 of 60 will equal approximately 90% saturation based on the oxyhemoglobin curve)
.
6.) Alveolar Ventilation (VA)= Volume of inspired air which participates in gas exchange per minute.
.
VA= (VT- VD) f
Normal is 4-6 L/min
VD can be estimated 1ml per lb of ideal body weight

7.) Dead Space Volume (VD)= volume wasted per breath

.
VD= VT- VA or VD= VE- VA normal is 1/3 tidal volume f

VDant= 1cc/lb of ideal body weight.

VD/VT ratio = (PaCO2 – PECO2)/ PaCO2 x 100

Relates to ventilation. Percentage of tidal volume that is unavailable for gas exchange. Acceptable
range 20-40%. Greater than 60% indicates need for mechanical ventilation
Causes for increase VD/VT = PE
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PECO2 is from capnography (ensure proper function)

8.) Alveolar Volume (VA) = no dot over V, used to calculate the volume of
breath which participates in gas exchange.

VA= VA/f or VA= VT-VD normal is 2/3 VT

.
9.) Minute Ventilation (Minute Volume) VE= Total air in and out of the lung in one minute
.
VE= Vt X f normal 5-7 L/min Use minute ventilation to control abnormal ABG’s

10.) Cardiac Output (CO) = amt of blood ejected from the heart per minute

CO= Stroke Volume X heart rate normal 4-8 L/min

11.) Airway Resistance (RAW)= Indicates RAW of an intubated patient on a vent caused by obstruction,
secretions or bronchospasm. Raw measured in a non intubated patient in a body box. Measured at a
standard flow of 0.5 L/sec (30 L/min). Normal is 0.6-2.4 cmH2O/Sec
R= Change Pressure over Volume
RAW= PIP-Plat Pressure
Flow/L/sec

12.) Compliance= Represents Lung elasticity, change in volume / change in pressure

Static= Vt/ Plat – Peep Normal 60-90 ml/cmH2O
Dynamic= Vt/ PIP- Peep Increase or Decrease = Increase or decreased RAW

Low static = High Plateau pressures (causes: ARDS, PN, ATX, pulmonary edema…)
Low dynamic=High PIP (causes: bronchospasm, secretions, increased RAW…)

13.) Duration of flow= determines amt a gas cylinder will last given a flow.
PSI x Cylinder Factor H=3.14 E= 0.28
Flow

Liquid Oxygen Systems: liquid weight x 860/2.5L/lb

First convert O2 weight in pounds to equivalent volume gaseous O2 in Liters (1lb Liquid O2= 344L of
gas O2). Second: divide pounds of Liquid o2 by LPM.
Pounds X 344
Flow

14.) Total Flow = Determines total flow using a high flow device such as a Venturi Mask. Ratio
from given oxygen percentage, add together then multiply by LPM.
24%=25:1, 28%= 10:1, 30%= 8:1, 35%= 5:1, 40%= 3:1, 50%= 1.7:1, 60%= 1:1, 100%= 0:1

15.) Gas Laws

Daltons- Total P= P1 + P2 + P3 …
Boyles Law- P1 x V1 = P2 x V2 (T constant) P and V inversely related
Charles Law- V1/T1 = V2/T2 (P constant) V and T are directly related
Gay- Lussacs Law- P1/ T2 = P2/T2 (Vconstant) P and T are directly related
Combined- P1 x V1 / T1 = P2 x V2 / T2
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16.) Temperature Conversion

F = (C x 9/5) + 32

C= (F – 32) x 5/9

K= C + 273

17.) Humidity

Relative Humidity= Absolute humidity (content/ capacity) x 100

RH at 37 degrees Celsius is 100%, water vapor pressure is 47 cmH20 and hold 44 ml of water vapor.
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18. ) Oxygen Index

OI = FIO2 x MAP / PaO2 Normal:

Identifies the need for ECMO and high frequency ventilation

19.) Hemodynamics
Cardiac Index= CI= Qt (ml/min) Cardiac performance equal to a patient’s
Body surface area cardiac output in L/min

SVR (dynes/sec)= MAP- CVP (mm Hg) x 80 PVR = MPAP – PCWP (mm Hg) x 80
Qt (L/min) Qt (L/Min)
PAP= Pulmonary artery pressure 25/12 mmHg
CVP= Central Venous Pressure 2-6 mm Hg
PCWP= Pulmonary capillary wedge pressure 6-12 mmHg

Normal PVR = 160 dynes

Normal SVR = 1440 dynes

Increases represent an increase in pulmonary or systemic vascular resistance

Delivery of Oxygen (DO2):

 DO2: O2 Delivery, (CaO2 x CO) x 10, norm is 1000mL/O2/min

 The ability of oxygen to tissues based on cardiac output and Hb

20.) Heliox Conversion: You must adjust the flow meter on a heliox system since He is less dense than O2

80/20 Mix= multiply observed flow by 1.8

70/30 Mix= multiply observed flow by 1.6

21.) Suction Catheter to ET tube size: No more than ½ the internal diameter of ETT or else improper
entrainment.
French divided by 3.14 = size in mm
b. normal adult sizes 12 - 14 fr
c. O.D. of catheter should not exceed 1/2 I.D.of airway
(1) to determine size of suction catheter for given ET tube: ETT size / 2 then x 3.14
(2) always round down – i.e. 7/2 x 3.14 = 10.99, use a 10 French
SHORT CUT
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Inner diameter -2 then x2 then use next lowest

size EX: Size 8.0 ETT
8-2 = 6 x 2 = 12 next size down = 10F

22.) Drug dilution

a. milligrams per ml.

0.5% solution contains ……. 5mg/ml

1% solution contains ………. 10mg/ml
2% solution contains ………. 20mg/ml
3% solution contains ………. 30mg/ml
4% solution contains ……… 40mg/ml

1:100 solution is 1%
1:200 solution is .5%
1:1000 solution is .05%

Example: How many milligrams are in 2 ml of a 3% solution?

30mg/ml • 2ml = 60mg.

a. You have 15 ml of 20% Mucomyst. You want a 15%

solution. How many ml will you have if you dilute it
to achieve this %?

Formula = Vol. #1 • Concentration #1 = Vol. #2 • Concentration #2

V1 • C1 = V2 • C2
15ml • 20% = • • 15%

300 = • • 15
15 15

20ml = • (V2)

 Note: if the question asks you HOW MUCH DO YOU ADD, then subtract the starting vol.
from the new vol.

Try this one: If you add 50 ml of NaCl to 150 ml of a 6% solution, what is the new % solution?

V1 x C1 = V2 x C2
150 x 6 = 200 x C2
900 = 200 x C2
900/200 = C2
4.5 = C2

23.) Solution concentrations (Ratio solutions) (% solutions)

a. Calculate the amount of active ingredient in a given vol. of medication.

1. Convert drug concentration to a fraction and set it up as a proportion.

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Example #1: How much active ingredient is in 0.7ml of 1:200 Isuprel?

(a 1 :200 drug concentration means that there is 1 part active ingredient to 200
parts solution)

Step #1: Set up proportion

1 ml active ingredient unknown amt. of active ingredient (X)

200mls total solution • .7ml solution

Step #2: Cross multiply

200x = .7ml

Step #3: Divide both sides by 200

200x = .7ml
200 200

X = .0035 ml = .0035 g = 3.5mg of active ingredient

Example #2: How much active ingredient would be in .5ml of Alupent? Alupent is 5%. -
a 5% drug concentration = 5 parts active ingredient to 100 parts solution ( 5 ml or 5grams
in 100 ml) step #1 = set up proportion

5 ml ingredient _X_
100 ml solution• .5ml

2.5 = 100x

_2.5_ = 100x
100 100

X = .O25 ml = .O25 g = 25 mg active ingredient

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24.) Calculate the VOLUME of medication needed to deliver a desired amt. of active ingredient.
(NEED TO CONVERT TO CONSISTENT
UNITS) Usually grams to milligrams

Example #1: How much 1:100 strength Isuprel would be needed to give a patient 2.5mg of
active ingredient by IPPB?

Step #1: change concentration to a fraction and convert to consistent units.

1:100 solution = 1 gram per 100 parts

solution (1 gram = 1000mg)

Step #2: set up equation

1000 mg = 2.5_____
100ml total solution • ml needed

Step #3: cross multiply

250ml = 1000X
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Step # 4: divide both sides by 1000

250 ml = 1000X
1000 1000
.25ml = • (.25 ml of Isuprel should be given)

Example #2: How much 4% Xylocaine would be needed to give a patient 100mg of active ingredient
by hand held neb. before a bronchoscopy?

Step #1: a 4% concentration = 4 parts active ingredient to 100 parts solution so there would be 4ml
or grams to 100 ml or grams of solution.
convert grams to milligrams
4 grams = 4000 mg/100 ml

Step #2: set up equation

4000 mg active ingredient = 100 mg

100ml solution • ml needed
Step #3:
10,000ml = 4000X '

Step #4: Solve equation

10,000 ml = 4000X
4000 4000

2.5 ml = • (2.5 ml of Xylocaine should be given)

25.) Clark’s Rule (Estimated Child Medication Dose)

Note: there are other formulas, but this seems to be more accurate because it takes into
account the child's weight.

Infant/Child dose = Child’s wt (lbs) • Adult dose

150

Example: A five year old child weighs 50 pounds. What dosage of brand • should he receive
if the adult dose of brand • is 30mg?

50 • 30 mg = 1 • 30 = 30 = 10 mg
150 3 3

OR

50 • 30 mg = 1500 = 10 mg
150 1 150
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26). Pack Year Smoking History (Hx)

# of packs per day • # of years smoked = pack years

Pack years over 40 is significant, but varies depending on the patient.
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27.) Karvonen's Formula (target heart rate / endurance training)

a. Pulmonary Rehab, endurance training, (treadmill, bike, swim etc.)

b. Patient must exercise at a level great enough to raise heart rate to a predetermined level
c. The increased heart rate reflects increased metabolic rate and work being performed by the patient
d. Target heart rate MUST be maintained for 20-30 min.
to have muscle training effect
e. Heart rate too low = exercise does no good, heart
rate too high = dangerous

target heart rate =[ % intensity (max heart rate - resting heart rate)] + resting heart rate

target heart rate = target rate for exercise period % intensity = 60 – 80%
Max heart rate = either of two formulas

1. (220 – age of
patient) Or
2. 210 - (patient age • 0.65)

resting heart rate = patient resting pulse

Example: for a 50 year old patient with resting pulse = 80/min, calculate the target heart rate
range for this patient during endurance training.

Step #1: calculate his max heart rate

220 - age = 220 - 50 = 170

Step #2: Use the target heart rate formula incorporating 60% intensity level

lowest target heart rate = [.60 (170 - 80)] + 80

= [.60 (90)] + 80
= 54 + 80
= 134 beats/min

Step #3: rework the target heart rate formula using 80% intensity level

highest target heart rate = ( .80 ( 170 - 80)] + 80

= [.80(90)] +80
= 72 + 80
= 152 beats/min

This patient should keep his heart rate in the range of 134 - 152 beats/min in order for his exercise
to be effective but not dangerous.
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28.) Predict the amount of mechanical deadspace needed to produce a desired PaCO2

[(VT-VDanatomic) - VDmechanical] • F • actual PaCO2 = [(VT-VDanatomic) – VDmechanical] • F •

desired PaCO2
VT = current tidal volume
VDanatomic deadspace = (1 ml/lb or 2.2m1/Kg
IBW) F = ventilatory rate
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Example: A 70Kg/154 lb. male on the ventilator in the control mode (apneic), has the following
ventilator settings; Vt = 1000 ml, RR = 12, FIO2 = 30%, and no added mechanical deadspace. ABG
= Ph 7.48, SaO2 = 95%,
BE = 0, PaO2 = 90, PaCO2 = 30. Your clinical goal is to produce a PaCO2 of 40.

[(1000-154)-0] • 12 • 30 = [(1000-154) - X] • 12 • 40

[846] • 12 • 30 = [846 – X] • 12 • 40

(846 • 360) = ( 846 • 480) - (X • 480)

304560 = 406080 - 480X
-406080 = - 406080
-101.520 = -480X
÷ -480 ÷ -480
211.5 = X (increase the patient’s
mech. VD to 212 ml
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29.) Calculation of VE for desired PaCO2

VE = actual VE x actual PaCO2

desired PaCO2

New rate = Current rate x actual PaCO2

desired PaCO2

New Vt = Current Vt x actual PaCO2

desired PaCO2
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30.) I:E Calculations

 I-time = Inspiratory Time,

 E-time = Expiratory time,
 TCT= total cycle time (I +E)
 I-time when compared to E-time will always be a 1: something ratio.
 Respiratory rate = 60 /TCT

 EXAMPLE: Calculate I:E ratio, rate and TCT if I-time is 1.2 seconds and E-time is 3 seconds.
 TCT = 1.2+ 3 = 4.2
 Rate = 60/4.2 =14
 I:E = TE/TI = 3/1.2 = 2.5, (I:E is 1:2.5)

 Example: The ventilator is set at 12 breaths per minute with an IE ratio of 1:3. How many seconds
for inspiratory time?
 Seconds per breath = 60 divided by 12 = 5 seconds
 TI=5/(1+3) =5/4=1.25 seconds
 Since I/E = 1:3, the expiratory time = 1.25 • 3 = 3.75 seconds

 Note: 1.25 + 3.75 = 5 seconds (the number of seconds per breath in this case.) ( a breath equals
inspiration + expiration)

 I:E = (PIP/Ve) -1
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Used when I-time and E-time are not known

 IE Ratio = [{flow/Ve} / 1.5] – 1
Used when I-time and E-time are not known

A. INSPIRATORY TIME is equal to the number of seconds per breath divided by the sum of the IE ratio.

TI = ( seconds per breath) / ( I + E ) seconds per breath = 60 divided by rate of breathing

Example: The ventilator is set at 12 breaths per minute with an IE ratio of 1:3. How many seconds
for inspiratory time?
seconds per breath = 60 divided by 12 = 5
seconds TI=5/(1+3) =5/4=1.25 seconds

Since I/E = 1:3, the expiratory time is 1.25 • 3 = 3.75 seconds!

Note: 1.25 + 3.75 = 5 seconds (the number of seconds per breath in this case.) ( a breath
equals inspiration + expiration)

B. CALC. I:E RATIO when I & E TIME are known

Example: (What is the IE ratio if inspiratory time is 0.4 seconds and expiratory time is
1.2 seconds?)
I:E = I time E time = 0.4 : 1.2 = 1:3
I time I time 0.4 0.4

Note: when the I time is LONGER than the expiratory time - divide both I and E time by the E
Time to get an inverse I:E ratio!

I time E time
I E = E time : E time

C. Calculate I:E RATIO when % I TIME is known

What is the I:E Ratio if the inspiratory time ratio is 25% or .25?

I Time % : 1 - I Time
IE = I Time % I Time

= 0.25 : 1 - 0.25 .75

0.25 0.25= .25 = 1:3

Example: What is the IE ratio if the I Time % is 33% or .33? (1:2)

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31.) CALCULATE the IE RATIO when the MINUTE VOLUME (VE) and the FLOW RATE
is known.
Given: VT = 800 ml (0.8L)
RR = 12
Flow = 40 L/min
IE ratio = (VE) : (flow rate – VE)
= (Vt • RR): [flow- (Vt • RR)]
= (0.8 • 12) :[40 - (0.8 • 12)]
= 9.6 : (40 - 9.6)
= 9.6 : 30.4
= 1:3.2 (divide both sides by 9.6)
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Example: What is the IE ratio if the Vt = 1000 ml, RR = 10 / min, flow rate = 50 L/ min?
(answer = 1:4)
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32.) CALCULATE AVERAGE INSPIRATORY FLOW RATE relative to VT, RR and IE ratio
Example: An MA-1 is set to deliver a VT of 700 ml at a rate of 12/min. What flow would be required
to generate an I:E ratio of 1:3?
FLOW = the sum of the I:E ratio multiplied by
the Minute ventilation

Flow = (I+E) • VE

In this case, the sum of the I:E ratio = 4 and the minute ventilation = 8.4 L

Therefore, flow = 4 • 8.4 LPM = 34 LPM

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33.) Calculate approximate VT using Flow Rate and Time

Example: Calculate the approximate VT when the flow rate is 8 L/min. and the I-Time is 0.5 seconds
(Flow = Vol/Time) so …
VT = Flow • I-Time
(change flow from liters per minute to liters per second)

8000 ml = 133 ml/sec

60 sec
VT = 133 ml/sec • 0.5 sec = 66.5 ml

Ventilator minimum flow calculation:

EX: VT 500, Rate 12, I:E 1:2
Step 1: Look at I:E and add (1+2 = 3)
Step 2: Multiply the minute ventilation x (I+E)

500 x 12 = 6L x 3 = 18L is the minimum flow required

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34.) VD/VT Ratio (Bohr Equation)
 Used to approximate the portion of tidal volume that is not taking part in gas exchange (wasted).
 MOST COMMONLY used to DOCUMENT the amount of deadspace (wasted ventilation) in
a patient with a PULMONARY EMBOLI!
2. Procedure:
a. Step 1:
Determine AVERAGE exhaled CO2
1. Collect the patient’s exhaled breaths in a Douglas bag, count
the number of breaths, calculate the average VT (total exhaled
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volume/total rate), then put gas sample through ABG analyzer to

measure CO2 value.
OR
2. Have the patient’s exhaled gas pass through a capnometer that can
read an AVERAGE value (not end tidal), then calculate the
patient’s average VT at the time of the test.
b. Step 2:
DRAW ABG at the same time Step 1 is being done. Analyze for PaCO2.

c. Step 3: Calculate Results

VD/VT = (PaCO2 – PECO2) / PaCO2

Example #1:
PBAR = 760 mmHg, PH2O = 47 mmHg, FiO2 = .60,
PECO2 = 22 mmHg
Arterial Venous
pH 7.42 7.35
PaCO2 33 46
PaO2 60 36
SaO2 .92 .68
Hgb 12 12

VD/VT = (33 – 22) / 33

= 11 / 33
= .33 or 33%
This means that 33% of the tidal volume doesn’t participate in gas exchange. So if the tidal volume is
330 mls, 110 mls are wasted because these 110 mls are not participating in gas exchange!
Example #2: may also work out problem as:
VD = ((PaCO2 – PECO2) / PaCO2) • VT
Based on a normal patient, where
VT = 500 ml, PaCO2 = 40,
and PECO2 = 28 …
VD = ((40-28) / 40) • 500 ml
= (12 / 40) • 500
= .3 • 500
= 150 ml
Thus, this patient’s physiologic deadspace (combination of anatomic and alveolar deadspace) is 150
mls. This patient’s VD/VT Ratio is 150/500, or .3 or 30%.
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35.) To compute the partial pressure of nitrogen in the

alveoli: PAN2 = PB – (PAO2 + PACO2 + PH2O)
= 760 – (100 + 40 + 47)
= 760 – 187
= 573 torr
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36.) Fick’s Law of Diffusion

Describes the movement of gas through a biological membrane:
Vgas = ((A • D) / T) • (P1 – P2)
A = area available for diffusion (cross section)
D = Diffusion co-efficient of the gas
T = Thickness of the membranes
P1 – P2 = the pressure gradient across the membrane

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37.) CvO2 Mixed Venous O2 Content

 O2 content of blood RETURNING from tissues

 Blood is drawn from PULMONARY ARTERY via BALOON TIPPED, FLOW DIRECTED
CATHETER (Swan Ganz) (distal lumen)

 CvO2 = (Hgb • 1.34 • SvO2) + (PvO2 • 0.003)

 Normal CvO2 = 15 Vol% (12 – 16 Vol%)

 Decreasing values indicate decreasing cardiac output
 SHORTCUT: Hb x 1.34 x SvO2
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38.) C(a-v)O2: Arterial –Venous O2 Content

 Measures O2 consumption of tissues

 Normal = 3.5 to 5.0 Vol%

 LOWER C(a-v)O2 indicate smaller amounts of oxygen removed per 100ml of blood
passing through the capillaries
 Value increases as CA decreases
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39.) Fick Method

Qt (L/min) = O2 Consumption = VO 2

(C(a-v)O2 • 10) (C(a-v)O2 • 10)

Normal VO2 = 250 ml/min (O2 Consumption)
Normal C(a-v)O2 = 5 ml/dl or 5 Vol%
Under normal conditions, the CARDIAC OUTPUT is DIRECTLY related to O2 CONSUMPTION

Increased VO2 = increased cardiac output

IF cardiac output fails to keep up with O2 consumption, the C(a-v)O2 increases (widens)!

Example: Calculate the Qt for a patient who has an O2 consumption of 250 ml/min and a C(a-v)O2 of
5 Vol%.

Qt = VO2 / (C(a-v)O2 • 10)

= 250 / (5 • 10)
= 250 / 50
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= 5 L/M

This formula can be rearranged for the calculation of estimated O2 consumption.

VO2 = Qt • (C(a-v)O2 • 10)

Example: What would the O2 consumption be if the patient’s measured Qt was 6 LPM and their C(a-
v)O2 was 5 Vol%.

VO2 = 6 • 5 • 10
= 30 • 10
= 300 ml/min (normal = 250 ml/min)

Another estimation of the average O2 consumption by an adult …

VO2 = 130 • BSA

Seems faster and easier but may give inaccurate results, especially if the patient has an
unusually high or low VO2)

Calculation of body surface area (BSA) in meters squared

BSA = ((4 • Kg) + 7) / (Kg + 90)

Average adult = 1.7 meters squared

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40.) Classic Shunt Equation

 Qs/Qt = (CcO2 – CaO2)/(CcO2 – CvO2)

 OR
 Qs/Qt = (A-aDO2) x 0.003 /(A-aDO2) x 0.003 + C(a-v)O2

CcO2: O2 Content of end capillary blood in the alveoli

 CcO2 = (1.34 • Hgb • SAO2) + (0.003 • PAO2)

Note: This equation requires that the patient be placed on a minimum of 30% FiO2 to insure that the
SAO2 is 100%
Modified Clinical Shunt Equation

 Qs/Qt = (P(A-a)O2 • 0.003)/[C(a-v)O2 + (P(A-a)O2 • 0.003)]

This formula requires that the patient’s hemoglobin be 100% saturated. This doesn’t happen until the
PaO2 = 150 at any given FiO2.
SHORT CUT:
Take first digit of A-aDo2 add +1 multiply times
5 EX: PAO2= 400
PaO2= 100
A-aDO2 = 400-100= 300
torr First digit = 3
Add 1 = 4 x 5 = 20 (SHUNT is 20%)
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41.) MAP (Mean Arterial Pressure)
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 MAP = Systolic BP + (2 • Diastolic BP)

3
 Note: you must take 2 times the diastolic blood pressure because the diastolic phase is two
times longer than the systolic phase.

 Normal MAP = 93 mmHg

 MAP of 60 mmHg is the minimum needed to maintain adequate tissue perfusion

 MAP is directly related to cardiac output and systemic vascular resistance

o MAP = SVR • CO

 Low MAP suggests patient with decreased cardiac output (CHF) or decreased SVR (loss
of venous tone).

 High MAP indicates hypertension

42.) Ideal Body Weight (given in Kg)

Males: 106 lbs for a 5 foot person

Add 6 lbs for every inch over 5 feet; convert into Kg by dividing 2.2

Ex: patient is 5’6

106 + (6 x6) = 142/ 2.2 = 65Kg

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43.) Mean Airway Pressure (PaW, MAP) Biggest influence on MAP is

PEEP 0.5 + {PIP –PEEP} x {Insp time /TCT}

44.) Rapid Shallow Breathing Index (RSBI). Weaning parameter, Values less than 105 indicate
adequate ventilation

F / vt

45.) Anion Gap

 Anion Gap= the difference in the measured cations and the measured anions in serum, plasma, or urine.
 Used to assess Metabolic Acidosis or alkalosis, normal around 8-16 mEq/L. Use MUDPILES to determine
cause of metabolic acidosis (high gap)
 = ( [Na+] ) − ( [Cl−]+[HCO3−] ) without potassium
 = ( [Na+]+[K+] ) − ( [Cl−]+[HCO3−] ) with potassium

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46.) Tubing Compliance

 Ct: Tube compliance aka compressible volume, volume lost to pt circuit, approx 3ml/cmH20 x
PIP, deduct from VT to find actual delivered tidal volume. VT-(PIP x 3) equals actual VT.

Ex: Vt 550 – (25 x3) = 475
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47.) Time Constant

 Time Constant: The given % of a passively exhaled breath of air will require a constant amount
of time to exhale
 Depends on the resistance and compliance of the lung
 TC= R x C (in liters)
 TC: Time constant, (Raw x CS)e,
 where e represents volume exhaled as a percent,
 1 is 63%,
 2 is 86%,
 3 is 95%
 5 is 100% exhaled.
 TC <3 leads to air trapping.

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48.) Spontaneous VT while on SIMV mode (on AC mode all VT is mechanical, on CPAP all VT is
spontaneous)
Only used to assess a spontaneously breathing patients VT from mechanical VT while on SIMV mode

Step 1. Obtain Total Ve from vent (spontaneous and mechanical Ve)

Step 2. Calculate Mech Ve (set VT x set Rate)
Step 3. Subtract Total Ve from Mech Ve
Step 4. Obtain sponatenous rate (Total rate – set rate)
Step 5. Divide #3 by #4

Total Ve (given from vent) –(VT mech x f mech)/ f spont (total rate – mech rate
set) Ex: SIMV 12
VT set 500
Tot Ve 8.1L
Total rate 22

SPONT VOLUME: 8.1L – 6L /10=250 ml

 Measured when machine in SIMV mode, represents what the patient is actually breathing on his/her
own.
 GOAL is 5-7 ml/kg, adjust PSV to achieve this