Which ventilator settings should be initiated for a patient who has just been intubated after a severe respiratory incident?

Initiating ventilator settings for a recently intubated patient requires careful consideration of the patient's respiratory status, oxygenation needs, and the goals of mechanical ventilation. The selected choice involves the VC/SIMV mode, which provides a combination of volume-controlled ventilation with assist/control breaths, allowing for both spontaneous breathing and mechanical support.

The tidal volume of 450 mL is appropriate for many patients, providing enough volume to ensure adequate ventilation based on the average sized adult. A breathing rate of 12 breaths per minute offers a good balance between supporting ventilation and allowing for spontaneous breaths, which is critical for patients recovering from respiratory incidents.

Using an FIO2 of 0.40 is reasonable in this context, given that the patient has experienced a severe respiratory incident, meaning their oxygenation might be compromised. This level will help achieve adequate oxygen saturation while minimizing the risks associated with oxygen toxicity, especially if the patient has the capacity to improve their respiratory function over time.

The application of 5 cm H2O of PEEP provides a beneficial effect by preventing alveolar collapse, promoting better lung recruitment, and enhancing oxygenation. This is particularly important in patients with acute respiratory distress to ensure that all parts of the lung continue to receive ventilatory support