A 14-month-old child, who weighs 13 kg and has a history of chronic lung disease (bronchopulmonary dysplasia), requires mechanical ventilation after surgery for correction of gastric reflux. The surgeon requests that the RT select ventilator parameters and develop a weaning plan for this child. The child has an uncuffed 4.5 oral endotracheal tube in place. SpO2 is 100% with manual ventilation and 100% O2. Sedation is prescribed to keep the child comfortable but allow spontaneous breathing.
This child needs a ventilatory strategy that takes into account his age, disease process, amount of sedation, and current ventilation needs. What would be the appropriate choices for his initial ventilator management in terms of mode, VT, set rate, FiO2, and PEEP level?
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