HMMM
Handy Medical Math Machine

Initial Ventilator Setup & Weaning Readiness

Protective ventilation principles (ARDSnet-based) + standard weaning criteria · Last reviewed: Jul 2026

Initial Setup

ParameterInitial value
Tidal volume6 mL/kg predicted body weight (4–8 mL/kg if ARDS)
Respiratory rate14–20/min, adjust to target pCO₂/pH
FiO₂Start 100%, wean down rapidly based on SpO₂/ABG
PEEPMinimum 5 cmH₂O, titrate to oxygenation & compliance
Plateau pressureKeep <30 cmH₂O
1
Weaning Readiness

Criteria met? (underlying cause improved, adequate oxygenation, haemodynamically stable, capable of spontaneous breathing)

Yes → perform Spontaneous Breathing Trial (SBT) 30–120 min.

2
Decision

SBT successful (adequate RR/tidal volume, no distress, haemodynamically stable)?

Yes → consider extubation (also assess airway protection & effective cough). No → return to supportive ventilation, identify cause of failure, retry the next day.

Detailed weaning protocols (rapid shallow breathing index, etc.) can be added as separate calculators in the Medical Calculator menu.