Medical ventilators support breathing function in the body. These lifesaving machines help your lungs work when you cannot breathe correctly or on your own. Patient-ventilator support is more often used in an intensive care unit. A respiratory therapist or a doctor will control the amount of oxygen delivered into your lungs by the machine. Critical care specialist plays a vital role in monitoring ventilator use. This is necessary for avoiding risks such as ventilator-associated pneumonia.
Under What Medical Conditions a Patient Might Require a Ventilator?
Mechanical ventilation is typically required following a breathing emergency, traumatic accident, or surgery. They are vital for patients that cannot breathe on their own. An artificial airway is used to connect the ventilator to the patient. This hollow breathing tube goes within the mouth, down to the trachea or central airway. Most patients typically need a ventilator until they can breathe on their own.
Respiratory failure occurs when you are not able to breathe on your own. This is regarded as a life-threatening emergency. The liver, heart, brain, kidneys, and other organs require oxygen in constant supply to work properly. The body won’t be able to do what it needs without oxygen. A ventilator helps get the oxygen your vital organs require to function.
Health conditions
You would require artificial life support if you are experiencing respiratory failure. Your body will be unable to get enough oxygen and expel carbon dioxide. Respiratory therapists and your doctor will place you on a breathing machine immediately if they think proper lung function is not happening. Several health conditions cause the body to reduce lung function.
Without adequate oxygen to the different organs, your body will not be able to function as necessary. The human body can barely survive minutes without proper oxygen. Your body may not be able to absorb oxygen or remove carbon dioxide in the following conditions:
- Asthma
- Brain injury
- Cardiac arrest
- Pneumonia
- Collapsed lung
- Acute respiratory distress syndrome (ARDS)
- Chronic obstructive pulmonary disease (COPD)
- Stroke
- Coma or loss of consciousness
- Upper spinal cord injuries
- Premature lung development (in babies)
- Guillain-barré syndrome
- Drug overdose
- Hypercapnic respiratory failure
- Lung infection
- Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
- Sepsis
- Myasthenia gravis
Patients with Covid-19 had terrible difficulty breathing. Thousands of patients could not breathe independently to support vital organs. Many of them developed ARDS. Mechanical ventilation played a key role in helping these patients. Respiratory therapists helped such patients when they were on ventilators to get better and start breathing on their own.
Surgical procedure
You may need to be placed on ventilator support if you are given general anesthesia for your procedure. Many anesthesia drugs make it difficult for patients to breathe easily when in a sleep-like state. Your anesthesiologist and a certified respiratory therapist will monitor your blood pressure. You may require ventilator support for a more extended period as follows:
During surgery
All muscles of the body are paralyzed when you are given general anesthesia. This includes vocal cords and muscles within the chest wall that help the lungs open and close. Without an artificial breathing machine, you won’t be able to breathe or maintain air pressure within the body. Critical care medicine is delivered after the surgery to stop the effects of anesthesia. You will be able to breathe on your own once the effects of anesthesia are gone. You will be removed from the ventilator, then.
After surgery
Ventilators become necessary when a patient who recently underwent surgery cannot breathe adequately on their own. This means tiny air sacs in their lungs are not getting the oxygen required to function correctly. The ventilator forces air into the lungs in people unable to breathe independently because of an illness or injury.
This is common among patients suffering from a chronic obstructive pulmonary disease (COPD) and other disorders that cause poor lung function. This may also happen because of an infection, lung injury, or other serious medical problem. Patients placed on ventilator support following surgery will be kept on the machine until they are well enough to breathe properly on their own.
Certain surgical procedures require the patient to be placed on ventilation machines for a brief period following the procedure. For instance, patients that underwent open-heart surgery need ventilators to provide support only until vitals are stable and they can be weaned off safely. They are not given any drug to remove the effects of heavy sedation. In such cases, the anesthesia is allowed to wear off on its own.
Length of Time Spent on Ventilator
The reason you are on the ventilator will determine the time you need to spend on it. Ventilators are essentially breathing machines that help with oxygen saturation in the body. A competent respiratory therapist must ensure there is not too little or too much oxygen in the body. These machines keep your lungs working. They cannot fix or treat a problem.
They can help you breathe while you are recovering or being treated for an illness. Ventilators are a vital lifesaving part of treatment support for patients of all ages. This includes babies and young children. In relation to this, the time you spend on a ventilator will essentially depend on the underlying condition that requires to be treated.
Your doctors will assess your condition and use the information provided by respiratory therapists to determine a treatment plan. Most patients come off ventilator support in a few hours or less. Others may require it to breathe normally for days, weeks, or longer. The physician will work with your family to develop a breathing plan that works best for you and your health.
Typically, patients are kept on ventilator machines for only a few hours or till the procedure is complete, if it is during surgery. This is seldom more than a few hours. You should expect a sore throat and mild pain once the sedation wears off. Moreover, in case of critical illness or severe cases, you may need to be on the ventilator for longer.
Generally, a family member is asked to remain with the patient during recovery time. Understanding that a ventilator won’t cure your illness or health condition is critical. Instead, it will only keep you breathing until the medications and treatments work. Your body needs to fight off the illness and infection on its own.
In any case, an endotracheal tube is not advised to be kept for more than a few weeks. This can cause permanent damage to the windpipe and vocal cords. Spontaneous breathing trials on multiple patients also showed that it was more difficult to wean off patients from ventilators when they were on them for more than a few weeks.
People with long-term complications usually require a surgical procedure called a tracheostomy. This is for patients who need long-term mechanical ventilation or cannot be weaned off it. The procedure involves creating an opening in the neck that bypasses the nose or mouth. One end of the tube is connected to the ventilator, while the other is inserted through the neck opening.
This procedure requires light sedation, and patients are often transferred to a long-term acute care facility. Respiratory care professionals in these facilities are trained in carrying out daily spontaneous breathing trials that help patients relearn how to breathe effectively once they are better.
Ventilators Can Save the Lives of People Injured in Accidents
Trauma accident victims are often in need of ventilator breathing. This is why respiratory care professionals are usually kept as part of the rapid response team. Lungs can be affected through a direct impact or a secondary injury elsewhere. Aggressive resuscitation also results in edema, bleeding, and inflammation of the lungs in many patients.
Such trauma can cause acute respiratory distress syndrome (ARDS) or acute lung injury (ALI). The goal of mechanical ventilation is to effectively preserve the lung and other injured organs. This includes the brain and heart. Ventilators work to protect trauma victims from oxygen deprivation. There are individualized approaches to mechanical ventilation depending on the type of traumatic injury.
The primary goal of trauma respondents is to avoid secondary tissue injury and hypoxia in patients. Mechanical ventilation may be initiated for various reasons besides respiratory compromises, such as intoxication, shock, agitation, brain injury, and combativeness. Respiratory therapists often employ lung-protective ventilation strategies to reduce the air pressure and volume delivered to the lungs.
Chest trauma
Chest trauma results in subsequent complications that can make breathing difficult. This also increases the cause of mortality in trauma. Enormous damage can be caused to major vasculature, including the lungs and heart, if the trauma victim sustains an injury to the thorax. Respiration can be significantly impeded by damage to the nervous and musculoskeletal systems.
Skeletal trauma
Skeletal trauma is usually in the form of rib fractures. This includes the scapulae, clavicles, vertebrae, sternum, and soft tissue injuries. These injuries can result in pneumonia, hypoxemia, and atelectasis. Lung expansion is impeded when two or more ribs are fractured. This also limits oxygenation in the body. Bone spurs and other penetrating wounds can cause invasion of the lung cavity. This inhibits lung expansion and causes trouble breathing.
Pulmonary contusion
Many patients suffer pulmonary contusions as a result of blunt trauma force. A few early signs include wheezing and hemoptysis. It can be difficult to find changes to the chest on an x-ray in the first 4 – 6 hours. Pulmonary contusions are self-healing in nature. They are usually resolved through lung-protective ventilation.
Indications for intubation
There are several facets to respiratory compromise. Inadequate chest compliance, increased respiratory rate, decreased tidal volume, pleural compromise, high oxygen requirements, failed lung mechanics, and head trauma or other severe associated injury are a few situations that may require intubation. Post-traumatic stress disorder, in extreme cases, may require artificial breathing support.
How Does a Ventilator Work?
Different types of ventilators provide varying levels of support. Your condition will determine the type of ventilator a respiratory therapist will use. These machines play an essential role in saving lives in ambulances and hospitals. You may want to install a ventilator machine at home if you require long-term support.
A medical ventilator uses air pressure to blow oxygenated air into your lungs and remove carbon dioxide. The airway includes the nose, mouth, throat, voice box, windpipe, and lung tubes. The respiratory therapist may push oxygen into your lungs in two ways – with a fitted mask or a breathing tube.
Face mask
This is known as noninvasive ventilation and has a low risk. A fitted plastic face mask covers the mouth and nose in this type of ventilation. The tube will be connected to the face mask to push air to your lungs. This method is usually used where physical breathing issues are less severe. Benefits of this type of ventilation include:
- More comfortable as compared to a breathing tube that is inserted into the throat or mouth.
- It doesn’t require sedation.
- It allows you to cough, talk, and swallow.
- Lowers the risk of complications and side effects, such as pneumonia and infection. There is a higher risk of complications with breathing tube ventilation.
Breathing tube
A breathing tube is inserted when the patient has a more severe condition. It is inserted into the throat and goes down the windpipe. This is also known as invasive ventilation. You will be sedated since the procedure can be painful. The other end of the breathing tube is connected to the ventilator. This forces air into your body to get the oxygen you require while healing from your injuries and illness.
Tracheostomy is required for patients that need to be on ventilators for an extended period. The surgeon will make a hole in front of the neck to insert the tube into your trachea. This will be placed below the vocal cords and connected to the mechanical breathing machine. Tracheostomy is used with occupational therapy to wean off patients who have been on ventilators for a long time.
Things to Expect Following Ventilator Support
You may have difficulty breathing without the ventilator if you have been on it for a long time. Once the ventilating machine stops breathing, you may find an aching or sore throat, weak chest muscles, and other symptoms. This happens because the chest muscles become weak over time. The ventilator is doing the breathing for you.
Weakened muscles may also be because of the medications given to you during the time. It may take days or weeks for your chest muscles and lungs to become normal. The doctor may recommend weaning you off the ventilator slowly. You won’t be taken off it completely. Instead, this will be gradual until your lungs are strong enough to handle the air pressure independently.
You may feel unwell after being taken off the ventilator if you have an infection, such as pneumonia. You should let your doctor know if you have any fever-like symptoms. Other muscles in the body will be weaker as well. You may not be able to move around quickly or perform your daily activities. You may need physical therapy to regain muscle strength and your everyday life.
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