A ventilator is a machine that takes over the work of breathing when you can't breathe enough on your own.
Why are ventilators used?
Ventilators are used to reduce the work of breathing. This makes sure that your body receives enough oxygen and that carbon dioxide is removed.
They are most often used during surgery if you're under anaesthesia (that is, if you're given medicine that makes you sleep and/or causes a loss of feeling.)
Ventilators are also used if a disease or condition impairs your lung function and prevents normal breathing. This includes infections, or an injury to your nervous system (like a brain or spinal cord injury), or for a person who is unconscious and unable to breathe on their own, such as in a drug overdose.
Ventilation does not heal you. Instead it gives you a chance to be stable while the medications and treatments help you to recover.
How does a ventilator work?
You are connected to the ventilator with a hollow tube (artificial airway) that goes in your mouth and down into your main airway (trachea). Ventilators blow air with oxygen into your airways and then your lungs. They also carry carbon dioxide, which is a waste gas, out of your lungs.
How are patients on ventilators monitored?
Most patients on a ventilator are monitored in an intensive care unit (ICU). Anyone on a ventilator in an ICU setting will be hooked up to a monitor that measures heart rate, respiratory rate, blood pressure and oxygen saturation (O2 sats). Other tests that may be done include chest x-rays and blood drawn to measure oxygen and carbon dioxide (blood gases).
Members of your healthcare team (including doctors, nurses and physiotherapists) use this information to assess your status and make adjustments to the ventilator if necessary.
What does being on a ventilator feel like?
Being on a ventilator isn’t usually painful, but the breathing tube may cause discomfort, coughing or gagging. Patients often receive medication, such as pain relief medicines and sedatives, to minimise pain, restlessness and anxiety.
Being on a ventilator may also affect your ability to talk and eat. Instead of taking food by mouth, you may require intravenous feeding (also known as IV feeding or parenteral nutrition) while on a ventilator.
How long is a ventilator used for?
Your healthcare team always tries to help you get off the ventilator as soon as possible. Some people may be on a ventilator for only a few hours or days, while others may require the ventilator for longer. This depends on many factors, such as include overall strength, how well your lungs were before going on the ventilator and how many other organs are affected (like your brain, heart and kidneys). Some people never improve enough to be taken off the ventilator.
Are there any risks with using a ventilator?
The main risk associated with using a ventilator is the risk of infection, as the breathing tube may allow germs to enter your lung. This risk increases the longer ventilation is needed and is highest around 2 weeks.
Another risk is lung damage caused by either over-inflation or repetitive opening and collapsing of the small air sacs (alveoli) of your lungs.
What should I expect when I'm taken off a ventilator?
'Weaning' is the process of taking you off a ventilator so that you can start to breathe on your own. People are usually weaned after they've recovered enough from the problem that caused them to need the ventilator.
- Weaning usually begins with a short trial. You stay connected to the ventilator, but you're given a chance to breathe on your own.
- Most people are able to breathe on their own the first time weaning is tried.
- Once you can successfully breathe on your own, the ventilator is stopped.
- If you can't breathe on your own during the short trial, weaning will be tried at a later time.
- If repeated weaning attempts over a long time don't work, you may need to use the ventilator long term.
- After you're weaned, the breathing tube is removed. You may cough while this is happening.
- Your voice may be hoarse for a short time after the tube is removed.
|Dr Helen Kenealy is a geriatrician and general physician working at Counties Manukau DHB. She has a broad range of interests and has worked in a variety of settings including inpatient rehabilitation, orthgeriatrics and community geriatrics.|