What is a mechanical ventilator?

A mechanical ventilator is a machine that helps a patient breathe (ventilate) when they are having surgery or cannot breathe on their own due to a critical illness. The patient is connected to the ventilator with a hollow tube (artificial airway) that goes in their mouth and down into their main airway or trachea. They remain on the ventilator until they improve enough to breathe on their own.

Why do we use mechanical ventilators?

A mechanical ventilator is used to decrease the work of breathing until patients improve enough to no longer need it. The machine makes sure that the body receives adequate oxygen and that carbon dioxide is removed. This is necessary when certain illnesses prevent normal breathing.

What are the benefits of mechanical ventilation?

The main benefits of mechanical ventilation are the following:

  • The patient does not have to work as hard to breathe – their respiratory muscles rest.
  • The patient's as allowed time to recover in hopes that breathing becomes normal again.
  • Helps the patient get adequate oxygen and clears carbon dioxide.
  • Preserves a stable airway and preventing injury from aspiration.

It is important to note that mechanical ventilation does not heal the patient. Rather, it allows the patient a chance to be stable while the medications and treatments help them to recover.

What are the risks of mechanical ventilation?

The main risk of mechanical ventilation is an infection, as the artificial airway (breathing tube) may allow germs to enter the lung. This risk of infection increases the longer mechanical ventilation is needed and is highest around two weeks. Another risk is lung damage caused by either over inflation or repetitive opening and collapsing of the small air sacs Ialveoli) of the lungs. Sometimes, patients are unable to be weaned off of a ventilator and may require prolonged support. When this occurs, the tube is removed from the mouth and changed to a smaller airway in the neck. This is called a tracheostomy. Using a ventilator may prolong the dying process if the patient is considered unlikely to recover.

What procedures can help a patient with an artificial airway connected to a mechanical ventilator?

  • Suctioning: This is a procedure in which a catheter (a thin, hollow tube) is inserted into the breathing tube to help remove secretions (mucus). This procedure may make the patient cough or gag, and it may be uncomfortable to watch. Also, secretions may develop a blood tinge from the act of suctioning. It is important to understand that this is a vital procedure for keeping the airways clear of secretions.
  • Aerosolized (spray) medications: A patient may need medications that are delivered through the breathing tube. These medications may be targeted to the airway or the lung and may be more effective when delivered this way.
  • Bronchoscopy: In this procedure, the doctor inserts a small light with a camera into the airway of the patient through the breathing tube. This is a very effective tool for checking the airways in the lungs. Sometimes the physician will take samples of mucus or tissue in order to guide the patient's therapy.

How long does the patient stay connected to the mechanical ventilator?

The main purpose of a mechanical ventilator is to allow the patient time to heal. Usually, as soon as a patient can breathe effectively on their own, they are taken off the mechanical ventilator.

The caregivers will perform a series of tests to check the patient's ability to breathe on their own. When the cause for the breathing problem is improved and it is felt that the patient can breathe effectively on their own, they are taken off of the mechanical ventilator.

Who are the caregivers who take care of the patient on a mechanical ventilator?

  • Physician: The physician is usually an anesthesiologist, pulmonologist, or intensivist (critical care physician). These doctors have special training in the art and science of mechanical ventilation and take care of these patients every day.
  • Nurse practitioner: The nurse practitioner helps the doctor evaluate the patient and write orders for therapy. Nurse practitioners in critical care areas are specially trained in the care of patients who are connected to mechanical ventilators.
  • Registered nurse: The registered nurses taking care of patients on mechanical ventilation have received special training in the care of these patients.
  • Respiratory therapist: The respiratory therapist is trained in the assessment, treatment, and care of patients with respiratory (breathing) diseases and patients with artificial airways who are connected to mechanical ventilators.
  • Patient care associate: The patient care associate is trained to care for patients in a critical care setting.

Last reviewed by a Cleveland Clinic medical professional on 11/29/2019.

References

  • National Heart, Lung, and Blood Institute. What Is a Ventilator? Accessed 12/6/2019.
  • American Thoracic Society. Mechanical Ventilator Accessed 12/6/2019.
  • Zakhary B, Uppal A. Zakhary B, Uppal A Zakhary, Bishoy, and Amit Uppal.Mechanical Ventilation. In: McKean SC, Ross JJ, Dressler DD, Scheurer DB. McKean S.C., Ross J.J., Dressler D.D., Scheurer D.B. Eds. Sylvia C. McKean, et al.eds. Principles and Practice of Hospital Medicine, 2e New York, NY: McGraw-Hill.

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