Updated Nov. 19, 2020
When a person cannot breathe on their own or maintain an open airway, they may require intubation and the use of a ventilator. Intubation is the process of inserting a breathing tube through the mouth and into the airway. A ventilator—also known as a respirator or breathing machine—is a medical device that provides oxygen through the breathing tube.
A ventilator may be used to assist with breathing during anesthesia or sedation for an operation or when a person is severely ill or injured and cannot breathe on their own. The breathing tube is connected to the ventilator. The ventilator pushes air into the lungs to deliver a breath, then allows the air to come back out, just as the lungs would do if they were able to.
What Is a Ventilator?
A ventilator is a machine that helps a person breathe.
Patients who have a medical problem that makes it hard for them to breathe well on their own or are undergoing anesthesia for surgery may be connected to a ventilator. Often, a person who is on a ventilator will receive medicine that makes them sleepy so the ventilator does the work of breathing. It allows the body to rest so it can heal.
A ventilator works similar to the lungs. It pushes a pulse of air into the lungs, as air would enter the lungs during an inhale. The ventilator can give more oxygen to the lungs than when a person breathes air. The ventilator also allows the air to come out of the lungs, as the lungs would do during exhalation. In this way, the person can receive the oxygen needed to keep all their organs alive, when their lungs are injured and not working properly.
People can remain conscious while on a ventilator. However, they may experience discomfort and may need medication to help them be more comfortable. Also, people usually cannot eat while on a ventilator, but they can receive nutrition from a tube that goes from their nose to their stomach.
What is a Breathing Tube?
A breathing tube also may be called an endotracheal tube. The tube is passed through the mouth or nose into the airway to keep air flowing into the lungs. A breathing tube may be placed if a person cannot maintain their airway due to an illness or accident, or if they cannot breathe without assistance, or both.
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What Is Intubation?
Intubation is the process when doctors insert an endotracheal tube, or breathing tube, into a person’s windpipe. It can be done to help patients breathe during surgery, or if patients can’t breathe on their own.
Why a Ventilator Might Be Needed
Your loved one might need to use a ventilator if their own lungs are unable to breathe for them or are not able to provide enough oxygen to the brain and body. This includes:
- During anesthesia. If a patient is having surgery requiring general anesthesia, the medication will suppress their ability to breathe on their own. A breathing tube would be placed and connected to a ventilator while they are under anesthesia. It would be removed and disconnected from the ventilator when they have come out of anesthesia and are able to breathe on their own.
- During a severe illness. Sometimes, a person who is very ill becomes too weak to breathe well enough to provide enough oxygen to the brain and body. A ventilator can do the work of breathing for them, allowing their body to rest and recover.
- After surgery or illness. Some patients may need to be on a ventilator for a while after their surgery or illness when a breathing tube was placed. This might include those who have had open-heart surgery or those who have lung-function problems, such as chronic obstructive pulmonary disease (COPD).
- After a severe accident. If a person is injured severely or sustains trauma, such as in a car accident, a ventilator can breathe for them until they are able to breathe on their own.
Side Effects of Being on a Ventilator
Although ventilators can be lifesaving, they also carry some risks and side effects.
- Infections, including pneumonia and sinus infections
- Muscle weakness
- Collapsed lung (pneumothorax)
- Vocal cord damage
- Atelectasis, or a portion of the lung not fully inflating
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When Your Loved One Is on a Ventilator
If you have a loved one on a ventilator, he or she may have difficulty with normal activities like talking, eating, or moving. Depending on the severity of your loved one’s condition, he or she may be conscious or unconscious.
The length of time on a ventilator also depends on the severity of your loved one’s condition. Some patients can be taken off ventilators within hours, particularly if it’s used for surgery. Others can stay on ventilators for days, months, or even years.
Being on a ventilator can be a difficult experience, especially if patients are conscious. If your loved one is on a ventilator, try to be there to help with whatever he or she is feeling.
Your loved one may feel frustrated or anxious because he or she can’t talk while on the ventilator. However, there are some ways to help promote communication, so speak with the nurse about what might work best.
Your loved one will receive food and nourishment through an IV (intravenous) or feeding tube while on the ventilator. Some patients with tracheostomy tubes can eat by mouth.
If your loved one is strong enough, he or she may sit up in a chair while on the ventilator.
Hospital alarms, alerts, and warnings
There are many devices that alert the UPMC care team of any problems or changes, even when not at your loved one’s bedside.
The small screen (monitor) above the patient’s bed tracks heart rhythm and blood pressure.
Both the monitor and the ventilator have alarms.
The alarms alert a staff member of a change in the patient’s condition, and each sound refers to a different condition.
Often when an alarm sounds, there’s no great cause for concern.
The problem may correct itself. Staff will check this from the nurses’ station.
Other times, a care team member may come to check the alarm.
How you can help your loved one
There are many ways you can comfort your loved one.
- Try talking to him or her as you normally would.
- Let your loved one know you’re nearby touching or holding his or her hand.
- You may be able to bring items from home, like a pillow or robe. Please check with the nurse first
- Your loved one might need special instructions for visitors, such as visiting times or time limits to the visit. These rules are in place to allow the staff to give your loved one the care he or she needs.
Coming off the Ventilator
The ventilator brings oxygen into the lungs and helps get rid of carbon dioxide from your loved one’s body.
Some people become dependent on a ventilator because of their medical problems. This may make it difficult to get the person off the ventilator.
When your loved one’s medical problems have improved — and he or she is well enough — “weaning” will begin.
Weaning, also known as a “weaning trial” or “spontaneous breathing trial,” is the process of getting the person off the ventilator. These trials are done daily to see if the person is ready to come off the ventilator.
If these trials go well, we will remove the breathing tube from their throat (a process called extubation). When a person comes off the ventilator because they can breathe on their own, they have achieved “ventilator liberation” (being freed from the ventilator.) Patients with tracheostomies will most likely need more time before the tracheostomy tube can be removed.
The length of the weaning process depends on factors like the severity of your loved one’s condition, and/or how long he or she was on the ventilator.
What to Expect After Being on a Ventilator
While many people can return to normalcy after being on a ventilator, other people may experience side effects. Post-Intensive Care Syndrome (PICS) refers to the physical or mental complications that someone may go through after being on a ventilator:
- Muscle weakness
- Cognitive problems
- Insomnia or trouble staying asleep
- Post-traumatic stress disorder (PTSD)
If your loved one is experiencing significant side effects after being on a ventilator, call your doctor for advice.
Your Loved One’s Care Team
The care team at UPMC is a group of professional and support staff who provide personal care to your loved one.
Medical team members include:
- Doctors, including lung or pulmonary specialists.
- Registered nurses.
- Respiratory (breathing) therapists.
Support staff team members include:
- Social workers.
- Nursing assistants.
- Physical and occupational therapists.
If you have any questions about your loved one’s care or hear something that you don’t understand, please ask one of these care team members.
We’re happy to answer your questions and ease any concerns.
Terms You Might Hear When Your Loved One Is on a Ventilator
Following are some terms you may hear from the care team:
- Alveoli (al-VEE-o-lie)— Tiny sac-like air spaces in the lungs. This is where the exchange of carbon dioxide and oxygen takes place.
- Arterial Blood Gas(ABG) — A sample of blood taken from an artery (usually in the wrist) to measure the oxygen and carbon dioxide levels. This is different from taking blood from the usual place, which is a vein.
- Atelectasis(at-a-LEK-tay-sis) — A condition that occurs when part of the lung collapses or compresses because of blockages in the airway.
- Bronchi(BRON-key) — The large airways of the lungs.
- Bronchioles(BRON-key-ols) — The smaller airways of the lungs.
- Bronchodilator(bronk-oh-DY-lay-tor) — A drug that relaxes the smooth muscles in the airways to help make breathing easier.
- Bronchoscopy (bronk-OSS-co-pee) — a procedure that lets doctors look at your lungs and air passages.
- Endotracheal(en-doh-TRAY-kee-ul) tube — A flexible plastic tube that a doctor or nurse inserts through the mouth or nose and into the trachea (which is the large airway from the mouth to the lungs). The care team might connect this tube to a ventilator.
- Extubation(ex-too-BAY-shun) — Taking the breathing tube out of the windpipe (trachea).
- Intubation(in-too-BAY-shun) — Putting the breathing tube into the windpipe (trachea).
- Pneumonia(nu-MO-nya) — Swelling and redness of the lungs caused by an infection.
- Pulse oximeter(ox-IM-eh-tur) — A probe that is placed on a finger, toe, or earlobe to measure the amount of oxygen in the blood.
- Respiratory(RES-per-uh-tor-ee) failure — A medical condition where a person can’t get enough oxygen or get rid of enough carbon dioxide through normal breathing. This may require the help of a ventilator.
- Restraints— Soft ties used to restrict movement so that your loved one does not pull out important breathing tubes or medicine lines.
- Suctioning(SUK-shun-ing) — Using a small plastic tube, called a suction catheter, to remove secretions from the breathing tube and the patient’s airways.
- Tracheostomy(tray-key-OS-tuh-me) or Trach (TRAKE) — An opening in the neck for placing a breathing tube. This may or may not be in place for a long time.
- Ventilation(ven-tuh-LAY-shun) — The exchange of air between the lungs and the atmosphere, leading to an exchange of oxygen and carbon dioxide in the bloodstream.
- Ventilator settings— Readings that show how much oxygen the patient receives, how often the ventilator is “breathing” for the patient, and the depth of each breath.
- Ventilator— A machine that breathes for the patient.
- Weaning trials— A process in which the ventilator breathing is slowly cut back to take the patient off the ventilator.
Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 700 doctors’ offices and outpatient centers, with locations in central and western Pennsylvania, Maryland, New York, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals.