What Is a Ventilator?
A ventilator (VEN-til-a-tor) is a machine that helps
people breathe. Its mainly used in hospitals. Ventilators:
- Get oxygen into the lungs
- Remove carbon dioxide (a waste gas that can be
toxic) from the body
- Help people breathe easier
- Breathe for people who have lost all ability to
breathe on their own
A ventilator often is used for short periods, such
as during surgery when you're under general anesthesia (AN-es-THE-ze-a). The
term "anesthesia" refers to a loss of feeling and awareness. General anesthesia
temporarily puts you to sleep.
The medicines used to induce anesthesia can disrupt
normal breathing. A ventilator helps make sure that you continue breathing
during surgery.
A ventilator also may be used during treatment for a
serious lung disease or other condition that affects normal breathing.
Some people may need to use ventilators long term or
for the rest of their lives. In these cases, the machines can be used outside
of the hospitalin long-term care facilities or at home.
A ventilator doesnt treat a disease or
condition. Its used only for life support.
Other Names for a Ventilator
- Mechanical ventilator
- Respirator
- Breathing machine
Who Needs a Ventilator?
Ventilators most often are used:
- During surgery if youre under anesthesia
(that is, if youre given medicines that temporarily put you to sleep
and/or cause a loss of feeling)
- If a disease or condition impairs your lung
function
During Surgery
If you have general anesthesia during surgery,
you'll likely be connected to a ventilator. The medicines used to induce
anesthesia can disrupt normal breathing. A ventilator helps make sure that you
continue breathing during surgery.
After surgery, you may not even know you were
connected to a ventilator. The only sign may be a slight sore throat for a
short time. The sore throat is caused by the tube that connected the ventilator
to your airway.
Once the anesthesia wears off and you begin
breathing on your own, the ventilator will be disconnected. The tube in your
throat also will be taken out. This usually happens before you completely wake
up from surgery.
However, depending on the type of surgery you have,
you could stay on a ventilator for a few hours to several days after your
surgery. Most people who have anesthesia during surgery only need a ventilator
for a short time, though.
For Impaired Lung Function
You may need a ventilator if a disease, condition,
or other factor has impaired your breathing. Although you may be able to
breathe on your own, it’s very hard work. You may feel short of breath
and uncomfortable. A ventilator can help ease the work of breathing. People who
can’t breathe on their own also use ventilators.
Many diseases, conditions, and factors can affect
lung function. Examples include:
- Pneumonia
(nu-MO-ne-ah) and other infections
- COPD
(chronic obstructive pulmonary disease) or other lung diseases
- Upper spinal cord injuries, polio,
amyotrophic lateral sclerosis (ALS), myasthenia gravis, and
other diseases or factors that affect the nerves and muscles involved in
breathing
- Brain injury or stroke
- Drug overdose
A ventilator helps you breathe until you recover. If
you can’t recover enough to breathe on your own, you may need a
ventilator for the rest of your life.
How Does a Ventilator Work?
Ventilators blow airor air with increased
amounts of oxygeninto the airways and then the lungs.
The airways are pipes that carry oxygen-rich air to
your lungs and carbon dioxide, a waste gas, out of your lungs. The airways
include your:
- Nose and linked air passages, called nasal
cavities
- Mouth
- Larynx (LAR-ingks), or voice box
- Trachea (TRA-ke-ah), or windpipe
- Tubes called bronchial tubes or bronchi, and
their branches
For more information on the airways, see the
Diseases and Conditions Index article on
How
the Lungs Work.
The Breathing Tubes
A ventilator blows air into your airways through a
breathing tube. One end of the tube is inserted into your windpipe and the
other end is attached to the ventilator.
The breathing tube serves as an airway by letting
air and oxygen from the ventilator into the lungs. The process of placing the
tube into your windpipe is called intubation.
Usually, the breathing tube is put into your
windpipe through your nose or mouth. The tube is then moved down into your
throat. A tube placed like this is called an endotracheal (en-do-TRA-ke-al)
tube.
In an emergency, you're given medicine to make you
sleepy and ease the pain of the breathing tube being put in your windpipe. If
it's not an emergency, the procedure is done in an operating room using
anesthesia. That is, you're given medicines that temporarily put you to sleep
and cause a loss of feeling.
An endotracheal tube is held in place by tape or
with an endotracheal tube holder. This often is a strap that fits around the
head.
Sometimes the breathing tube is put into the
windpipe through a hole in the front of the neck. A surgeon makes the hole
using a procedure called tracheotomy (TRA-ke-O-to-me). The tube put into the
hole is sometimes called a "trach" tube.
A tracheotomy is done in an operating room.
You’ll be under anesthesia, so you won’t be awake or feel any pain.
Specially made ties, or bands, that go around the neck hold the trach tube in
place.
Both types of breathing tubes pass through your
vocal cords. Thus, while a breathing tube is in your throat, it affects your
ability to talk.
Endotracheal tubes are mainly used for people who
are on ventilators for shorter periods. The advantage of this tube is that it
can be placed in an airway without surgery.
Trach tubes are used for people who need ventilators
for longer periods. For people who are awake, this tube is more comfortable
than the endotracheal tube. Under certain conditions, a person who has a trach
tube may be able to talk.
The Ventilator
A ventilator uses pressure to blow air or a mixture
of other gases (like oxygen and air) into the lungs. This pressure is known as
positive pressure. You usually breathe out the air, but sometimes the
ventilator does this for you.
A ventilator can be set to “breathe” a
set number of times a minute. Sometimes it’s set so that you can trigger
the machine to blow air into your lungs. But, if you fail to trigger it within
a certain amount of time, the machine automatically blows air to keep you
breathing.
Rarely, a ventilator called a chest shell is used.
This type of ventilator works like an iron lung—an early ventilator used
by many polio patients in the last century. However, the chest shell
isn’t as bulky and confining as the iron lung.
The chest shell fits snugly to the outside of your
chest. A machine creates a vacuum between the shell and the chest wall. This
causes your chest to expand, and air is sucked into your lungs. No breathing
tube is used with a chest shell.
When the vacuum is released, your chest falls back
into place and the air in your lungs comes out. This cycle of vacuum and
release is set at a normal breathing rate.
What To Expect While on a Ventilator
Ventilators normally dont cause pain. The
breathing tube in your airway may cause some discomfort. It also affects your
ability to talk and eat. If your breathing tube is a trach tube, you may be
able to talk. (A trach tube is put directly into your windpipe through a hole
in the front of your neck.)
Instead of food, you may be given nutrients through
a vein in your body. If youre on a ventilator for a long time,
youll likely get food through a feeding tube. The tube goes through your
nose or mouth or directly into your stomach or small intestine through a
surgically made hole.
A ventilator greatly restricts your activity and
also limits your movement. You may be able to sit up in bed or in a chair, but
you usually cant move around much. If you need to use a ventilator long
term, you may get a portable machine. This machine allows you to move around
and even go outside, although you need to bring your ventilator with you.
Sometimes the ventilator is set so that you can
trigger the machine to blow air into your lungs. But, if you fail to trigger it
within a certain amount of time, the machine automatically blows air to keep
you breathing.
Ongoing Care
While you’re on a ventilator, your health care
team will closely watch you. The team may include doctors, nurses, and
respiratory therapists. You may need periodic
chest
x rays and regular
blood
tests to check the levels of oxygen and carbon dioxide (blood gases) in
your body.
These tests help your health care team find out how
well the ventilator is working for you. Based on the test results, they may
adjust the ventilator’s airflow and other settings as needed.
Also, a nurse or respiratory therapist will suction
your breathing tube from time to time. Suctioning removes mucus from your
lungs. It will cause you to cough. You also may feel short of breath for
several seconds. You may get extra oxygen during suctioning to relieve this
symptom.
What Are the Risks of Being on a Ventilator?
Infection
One of the most serious and common risks of being on
a ventilator is
pneumonia.
Ventilator-associated pneumonia (VAP) is linked to the breathing tube
that’s put in your airway when you’re on a ventilator.
The tube may make it easy for bacteria to get into
your lungs. It also makes it hard for you to cough. Coughing is important for
helping to get rid of bacteria.
VAP is a major concern for people using ventilators
because they’re often already very sick. Pneumonia may make it harder to
treat their original disease or condition.
VAP is treated with antibiotics. You may need
special antibiotics if the VAP is due to bacteria that are resistant to
standard treatment.
Another risk of being on a ventilator is sinus
infection. This is more common in people who have an endotracheal tube. (This
tube is put into your windpipe through your mouth or nose.) Sinus infections
are treated with antibiotics.
Other Risks
Using a ventilator also can put you at risk for
other problems, such as:
- Pneumothorax
(noo-mo-THOR-aks). This is a condition in which air leaks out of the lungs and
into the space between the lungs and the chest wall. This can cause pain and
shortness of breath, and it may cause one or both lungs to collapse.
- Lung damage. Pushing air into the lungs with too
much pressure can harm the lungs.
- Oxygen toxicity. High levels of oxygen can damage
the lungs.
These problems may occur because of the forced
airflow or higher levels of oxygen from the ventilator.
Using a ventilator also can put you at risk for
blood clots and serious skin infections. These problems tend to occur in people
who have certain diseases and/or who are confined to bed or a wheelchair and
must remain in one position for long periods.
Another possible problem is damage to the vocal
cords from the breathing tubes. If it’s hard for you to speak or breathe
after your breathing tube is taken out, let your doctor know.
What To Expect When Youre Taken Off of a
Ventilator
“Weaning” is the process of taking you
off a ventilator so that you can start to breathe on your own. People usually
are 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 are weaned, the breathing tube is taken
out. You may cough while this is happening. Your voice may be hoarse for a
short time after the tube is taken out.
Key Points
- A ventilator is a machine that helps people
breathe. Ventilators:
- Get oxygen into the lungs
- Remove carbon dioxide from the body
- Help people breathe easier
- Breathe for people who have lost all ability
to breathe
- Ventilators dont treat diseases or
conditions. Theyre used only for life support.
- A ventilator often is used for short periods,
such as during surgery when youre under anesthesia (that is, if
youre given medicines that temporarily put you to sleep and cause a loss
of feeling). The medicines used to induce anesthesia can disrupt normal
breathing. A ventilator helps make sure that you continue breathing during
surgery.
- A ventilator also may be used during treatment
for a serious lung disease or other condition that affects normal
breathing.
- Ventilators blow airor air with increased
amounts of oxygeninto the airways and then the lungs. This is done using
a breathing tube. Usually, the breathing tube is put into your windpipe through
your nose or mouth. Sometimes the tube is put directly into your windpipe
through a hole in the front of your neck.
- Ventilators normally dont cause pain, but
they greatly restrict your activity and limit your movement. People who need
ventilators long term may get portable machines. These machines let them move
around.
- One of the most serious and common risks of being
on a ventilator is
pneumonia.
Ventilator-associated pneumonia (VAP) is linked to the breathing tube
that’s put in your airway when you’re on a ventilator. The tube may
make it easy for bacteria to get into the lungs. It also makes it hard for you
to cough. Coughing is important for helping to get rid of bacteria.
- Other risks of being on a ventilator include
pneumothorax,
lung damage, oxygen toxicity, blood clots, and serious skin infections.
- “Weaning” is the process of taking
you off a ventilator so that you can start to breathe on your own. People
usually are weaned after they’ve recovered enough from the problem that
caused them to need the ventilator. Most people are able to breathe on their
own the first time weaning is tried. If repeated weaning attempts over a long
time don’t work, you may need to use the ventilator long term.
- Most people need ventilators only for a short
time. If you need to be on a ventilator for a long time, you may be able to
have one at home.
Links to Other Information About Ventilators
Clinical Trials
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