Sometimes, a person cannot breathe on their own or keep their airway open. In these cases, they may need intubation and a ventilator.
Intubation means putting a breathing tube through the mouth and into the airway. The breathing tube connects to the ventilator.
A ventilator is a medical device that gives oxygen through a breathing tube. It is also known as a respirator or breathing machine.
A ventilator may help a person breathe during an operation. It may also help a person who is severely ill or injured and cannot breathe on their own.
What Is a Ventilator?
A ventilator is a machine that helps a person breathe. Ventilation gets oxygen to the blood to keep their organs healthy, even when their lungs are not working properly.
A ventilator pushes air through the breathing tube to inflate the lungs. The ventilator can give more oxygen to the lungs than is generally in the air.
The ventilator then allows the air to come out of the lungs as it would during exhalation.
People can stay conscious while on a ventilator. However, they may get medicine to make them sleepy. Then, the ventilator does the work of breathing and allows the body to rest to heal.
Also, people usually cannot eat while on a ventilator. They typically receive nutrition from a tube from their nose to their stomach.
What Is a Breathing Tube?
A breathing tube or endotracheal tube goes through the mouth or nose into the airway to keep air flowing into the lungs. A breathing tube can help a person who cannot maintain their airway. The process of placing a breathing tube is intubation.
What Is Intubation?
Intubation is when doctors put an endotracheal or breathing tube into a person’s windpipe. It can help a person breathe during surgery or if they can’t breathe on their own.
Why Your Love One May Need a Ventilator
Your loved one may need a ventilator if their lungs cannot breathe for them. In this case, breathing normally may not get enough oxygen to their brain and body.
This includes:
- During anesthesia. If a person is having surgery under general anesthesia, the medicine will make them unable to breathe on their own. A breathing tube connected to a ventilator will breathe for them while they are under anesthesia. The doctor then takes it out when the person wakes up and can breathe on their own.
- During a severe illness. When a person is very ill, they may find they are too weak to breathe on their own. A ventilator can do the work of breathing for them, allowing their body to rest and recover.
- After surgery or illness. Some people may need to stay on a ventilator for a while. This might include those who have had open-heart surgery or lung-function problems, such as chronic obstructive pulmonary disease.
- After a severe accident. A severely injured person who has sustained trauma, such as during a car accident, may need a ventilator to breathe for them.
Ventilator Side Effects
Although ventilators can save lives, they also carry some risks and side effects. These can include:
- Infections, including pneumonia and sinus infections.
- Muscle weakness.
- Collapsed lung, called a pneumothorax.
- Vocal cord damage.
- Atelectasis, or a portion of the lung not fully inflating.
When Your Loved One Is on a Ventilator
Depending on the severity of your loved one’s health issue, they may remain conscious or become unconscious. They may struggle with everyday activities like talking, eating, or moving if awake.
How long they stay on a ventilator depends on their health issue’s severity. Doctors can remove some people from ventilators within hours, which is typical during surgery. Others can stay on ventilators for days, months, or even years.
Being on a ventilator can prove difficult. That’s especially true if the person is conscious. If your loved one is on a ventilator, try to help with whatever they are feeling.
Limited communication
Your loved one may feel frustrated or anxious because they can’t talk while on the ventilator. However, there are ways to help them communicate. Speak with their nurse about what might work best.
Eating
Your loved one will receive food through a tube while on the ventilator. The feeding tube may go into their arm or nose. Some people with tracheostomy tubes — a breathing tube through a hole in the throat — can eat by mouth.
Activity
If your loved one is strong enough, they may sit in a chair while on the ventilator.
Hospital alarms, alerts, and warnings
The UPMC care team uses many devices with alerts that warn them of any problems or changes, even when they’re not nearby. The small screen (monitor) above the person’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 your loved one; each sound is a different issue. Often when an alarm sounds, there’s no great cause for concern. Other times, a care team member may come to check or reset the alarm.
The problem may fix itself. Staff will check this from the nurses’ station.
How you can help your loved one
There are many ways you can comfort your loved one.
- Try talking to them as you usually would.
- Let your loved one know you’re nearby, touching or holding their hand.
- You can bring comfort 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. These rules allow the staff to give your loved one the care they need.
Coming off the Ventilator
The ventilator brings oxygen into the lungs and helps remove 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 they are well enough — “weaning” will begin. Weaning, also known as a “weaning trial” or “spontaneous breathing trial,” is getting the person off the ventilator. The care team will perform these trials daily to see if the person is ready to come off the ventilator.
If these trials go well, the care team will remove the breathing tube from the throat. This is extubation. “Ventilator liberation” is when a person comes off the ventilator and can breathe on their own, free from the ventilator.
How long the weaning process takes depends on the health issue’s severity and how long they were on the ventilator. People with tracheostomies will likely need more time before doctors can remove the tube and ventilator.
What to Expect After Coming off a Ventilator
Though many people can return to normalcy after coming off a ventilator, other people may experience side effects. Post-intensive care syndrome refers to the physical or mental complications that someone may go through after coming off a ventilator.
These may include:
- Muscle weakness.
- Cognitive problems.
- Depression.
- Insomnia or trouble staying asleep.
- Post-traumatic stress disorder.
Call your doctor for advice if your loved one has side effects after coming off a ventilator.
Your Loved One’s Care Team
The health care workers who care for your loved one include medical team members and support staff.
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 questions about your loved one’s care or hear something you don’t understand, ask the care team for clarity.
We’re happy to answer your questions and ease any concerns.
Terms You Might Hear When Your Loved One Is on a Ventilator
Here are some words you may hear from the care team:
- Alveoli (al-VEE-o-lie). Tiny sac-like air spaces in the lungs. This is where carbon dioxide and oxygen move between blood and air.
- Arterial blood gas (ABG). A blood sample from an artery (usually in the wrist) that measures 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 health issue occurs when part of the lung collapses or compresses because of blockages in the airway.
- Bronchi (BRON-ky). 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 test 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 puts into the 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 on a finger, toe, or earlobe measures the amount of oxygen in the blood.
- Respiratory (RES-per-uh-tor-ee) failure. A health issue in which a person can’t get enough oxygen or get rid of enough carbon dioxide through normal breathing. This may need the help of a ventilator.
- Restraints. Soft ties that restrict movement so that your loved one does not pull out their breathing tube or medicine lines.
- Suctioning (SUK-shun-ing). A small plastic tube (a suction catheter) removes liquid from the breathing tube and the person’s airways.
- Tracheostomy (tray-key-OS-tuh-me) or trach (TRAKE). An opening in the throat for placing a breathing tube. This may or may not stay there for a long time.
- Ventilation (ven-tuh-LAY-shun). The gas exchange between the lungs and the air leads to an exchange of oxygen and carbon dioxide in the bloodstream.
- Ventilator settings. Readings that show how much oxygen the person receives, how often the ventilator is “breathing,” and the depth of each breath.
- Ventilator. A machine that breathes for the person.
- Weaning trials. A process in which the ventilator breathing is slowly cut back to take the person off the ventilator.
Editor's Note: This article was originally published on , and was last reviewed on .