Critical Care Medicine for UPSC CMS: Ventilator Settings, Inotropes and ICU Scoring Systems

Ventilator Settings

AC (Assist-Control): Set RR, VT (6-8 mL/kg PBW), PEEP (5), FiO2 (titrate to SpO2 >92%).
SIMV: Synchronized intermittent mandatory ventilation.
PS (Pressure Support): Patient-triggered, pressure-limited.
CPAP: Continuous positive airway pressure (spontaneous breathing).

Inotropes/Vasopressors

| Drug | Mechanism | Dose | Effect |
|------|-----------|------|--------|
| Norepinephrine | Alpha + Beta-1 | 0.01-0.5 mcg/kg/min | Vasoconstriction |
| Dopamine | Dose-dependent | 2-20 mcg/kg/min | Dose-dependent |
| Dobutamine | Beta-1 | 2-20 mcg/kg/min | Inotropy |
| Vasopressin | V1 receptor | 0.03 U/min | Vasoconstriction |

Scoring Systems

APACHE II: Age + 12 acute physiologic variables + chronic health + surgical status.