Mechanical Ventilation Setting Peak Flow

The easiest rule of thumb to follow is that a patient requires a peak flow roughly four times that of the minute ventilation (if the MV is 15 liters, the patient requires a PF of >60 liters). However if the patient is breathing spontaneously, then bedside adjustment is required to ensure that flow matches patient efforts. The peak flow should be set slightly higher if a decelerating waveform pattern is being used, and, in particular, those with airflow obstruction.

Varying the peak flow rate. In panel 1 the peak flow (PF) is 40 l/min and the patient is slightly dysynchronous. In the middle panel the PF is 50 l/min and the patient remains dysynchronous. In the last panel the PF is 100 l/min, but the peak airway pressure is too high.

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