Posted by an Internal Medicine Resident:

A 20-year-old patient with a genetic syndrome is ventilated in the intensive care unit. The patient is 3’11” tall and 70 pounds. Based on the patient’s height, their ideal body weight would be 48 pounds, with ventilation at 88-132 mL; however, the patient’s current weight suggests 128-192 mL. The treating resident asked the community for advice on how to proceed. A respiratory specialist on Figure 1 advised starting with 125 mL, and monitoring peak and mean airway pressures. The treating resident later reported was working well for the patient.