A practical, bedside-first reference for the mechanics every ICU, ED, and respiratory therapy clinician needs cold: predicted body weight (PBW) and why tidal volume is never set by actual weight, step-by-step protective ventilation setup, plateau pressure vs. driving pressure, the ARDSNet PEEP/FiO2 table, the Berlin Definition of ARDS, a systematic 5-step method for reading any arterial blood gas, the ROX index for high-flow nasal cannula, spontaneous breathing trials, and a full alarm-troubleshooting section (high pressure, auto-PEEP, asynchrony, sudden desaturation). Also covers sedation strategy, prone positioning, neuromuscular blockade, and special populations, plus intubation and transport checklists. Every threshold and table is transcribed from its peer-reviewed source and cited by DOI/PMID (ARDSNet NEJM 2000, Berlin Definition JAMA 2012, Amato driving pressure NEJM 2015, Roca ROX index 2016/2019, ATS/ESICM/SCCM 2017) — nothing is invented. The companion Excel workbook calculates PBW, target Vt, driving pressure, compliance, P/F ratio, and ROX index live from your own inputs, cross-checked against three worked cases. Educational reference only — not medical advice, not a medical device, and not a substitute for your institution's protocol or clinical judgment.
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