Mechanical ventilation is a type of therapy that helps you breathe or breathes for you when you can’t breathe on your own. You might be on a ventilator during surgery or if your lungs aren’t working properly. Mechanical ventilation keeps your airways open, delivers oxygen and removes carbon dioxide.
Mechanical ventilation is a form of life support that helps you breathe (ventilate) when you can’t breathe on your own. This can be during surgery or when you’re very sick.
While mechanical ventilation doesn’t directly treat illnesses, it can stabilize you while other treatments and medications help your body recover.
A ventilator is a machine that helps you breathe. Just like crutches support your weight, the ventilator partially or completely supports your lung functions. A ventilator:
Providers can adjust the settings on the machine to meet your specific needs.
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Intubation and mechanical ventilation often happen together, but they’re not the same. When a provider intubates, they put a tube down your throat into your airway (trachea). Then, a provider will connect the tube in your throat to a ventilator. Sometimes, a face mask connects you to the ventilator and you don’t have to be intubated.
Modern mechanical ventilators use positive pressure to push air into your lungs. Positive pressure ventilation can be invasive or noninvasive.
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Providers use mechanical ventilators to support your breathing when you can’t breathe on your own. Mechanical ventilation:
You might need mechanical ventilation:
Specific conditions that might require you to have mechanical ventilation include:
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The time you need mechanical ventilation depends on the reason. It could be hours, days, weeks, or, rarely, months or years. Ideally, you’ll only stay on a ventilator for as little time as possible. Your providers will test your ability to breathe unassisted daily or more often.
In general, if you need to be on a ventilator for a long time (two weeks or so), a provider will switch you from an endotracheal tube to a tube in your neck (tracheostomy).
To start invasive mechanical ventilation, a provider will:
These are the general steps for starting mechanical ventilation. Some of these steps may be slightly different depending on your specific situation, especially in an emergency.
While you’re on a ventilator, providers will perform additional procedures to treat you or prevent complications. These include:
Your provider will connect you to additional machines to monitor how your body is working. This includes monitoring your:
They may also look at your lungs with chest X-rays or test your oxygen and carbon dioxide levels with blood tests.
Suctioning is important for keeping your airways clear. A provider will insert a catheter (a thin tube) into the breathing tube to help remove mucus (secretions). It might make you cough or gag. Loved ones may find it uncomfortable to watch.
Your provider might give you aerosolized (spray) medications through your breathing tube. These medications work best when you breathe them directly into your airways or lungs. Your provider will also give you medication into your veins through an IV.
You can’t eat or drink normally while you’re on a ventilator and intubated. Your provider will give you liquid nutrition, usually through a tube that goes through your nose and into your stomach. They’ll give you fluids through an IV in a vein.
Your providers will sit you up regularly. They may get you up and walking sometimes.
Providers use a bronchoscope to look at the airways in your lungs. They insert a small, lighted camera through the breathing tube and into your lungs. Sometimes, they’ll take samples of mucus or tissue for testing.
Providers treat you in the intensive care unit (ICU) when you need mechanical ventilation. They can closely monitor you there. All providers in the ICU are specially trained to care for people who need mechanical ventilation. Providers who might care for you include:
While you’re on a ventilator, your provider will try to keep you as awake as possible while ensuring you’re calm and comfortable. They’ll use medications as needed to keep you relaxed. It’s not uncommon for you to be awake (conscious), but you might feel sleepy, confused, or not fully aware of what’s happening.
Sometimes, depending on how sick you are, your provider may need to keep you deeply sedated (asleep) so you’re not aware and your body can recover. Your arms might be restrained to prevent you from hurting yourself by pulling on the tube.
Providers will perform tests to see if you can breathe on your own before taking you off the ventilator. The ET tube stays in place for these tests. When your condition has improved and you can breathe on your own, your provider will remove the ET tube to take you off of mechanical ventilation.
You might have a sore throat or mouth, or your voice may be hoarse after your provider removes the ET tube.
After removing the tube (called extubation) your provider may place you on other devices to help you breathe. These include noninvasive ventilation (with a mask) or oxygen masks. Sometimes, a provider may have to intubate you again and put you back on mechanical ventilation.
Benefits of mechanical ventilation include:
Providers take steps to avoid complications of mechanical ventilation. However, there can still be some risks, including:
How long it takes to recover from mechanical ventilation depends on why you needed it and how long you were on it. Your provider can tell you what to expect and how to take care of yourself while you recover.
PEEP (positive end-expiratory pressure) is a ventilator setting that providers use when someone’s on mechanical ventilation. Several conditions, like ARDS or lung injury, can cause the air sacs (alveoli) in your lungs to collapse when you breathe out. When this happens, oxygen won’t be able to get into those collapsed air sacs and then to your bloodstream.
PEEP uses positive airway pressure (pushing air into your lungs) to keep the alveoli open while you exhale. It supports them so they don’t collapse. This can increase the amount of oxygen getting to your tissues.
Some of the risks of PEEP include lung overinflation leading to lung collapse (pneumothorax) or low blood pressure.
CPAP and PEEP are similar in that they both use positive pressure. CPAP (continuous positive airway pressure) provides the same amount of positive pressure when you inhale and exhale. This is used to keep your airway open (like in obstructive sleep apnea) or to prevent your alveoli from collapsing. CPAP is often used with noninvasive ventilation.
In contrast, PEEP uses positive pressure only when you exhale. This is a ventilator setting that providers use with many different ventilator modes, or varieties of mechanical ventilation, and has the same effects as CPAP. Providers use PEEP when you’re on mechanical ventilation and can’t breathe on your own.
Mechanical ventilation can save your life in an emergency or if you get very sick and can’t breathe on your own. It’s not meant to treat conditions, but it can give your body the time it needs to get better. In cases of very serious or worsening illness, some people may not be able to breathe on their own again.
Regardless of your health, make sure your provider and your family know your wishes for your medical care. Having discussions about your goals and setting up advanced directives and healthcare power of attorney is an important step. This can help your loved ones if they need to make decisions on your behalf.
Last reviewed on 09/27/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy