If Pplat 30 cm H2O decrease VT by 1mlkg steps minimum 4 mlkg If Pplat 25 cm H2O and VT 6 mlkg increase VT by 1 mlkg until Pplat 25 cm H2O or VT 6 mlkg If Pplat 30 and breath stacking or dyssynchrony occurs may increase VT in 1mlkg increments to 7 or 8 mlkg if Pplat remains 30 cm H2O pH GOAL 730745

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