By National Institutes of Health
A ventilator is a machine that helps people breathe. It's 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
Who needs a ventilator? Ventilators are used for:
A ventilator often is used for short periods, such as during surgery when you're under general anesthesia. 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.
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.
- Pneumonia 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 a Ventilator Works
Ventilators blow air—or air with increased amounts of oxygen—into 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:
- Nose and linked air passages, called nasal cavities
- Larynx, or voice box
- Trachea, or windpipe
- Tubes called bronchial tubes or bronchi, and their branches
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 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 tube.
Endotracheal Tube Ventilators
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. The tube put into the hole is sometimes called a "trach" tube.
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.
What To Expect While on a Ventilator
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 don't cause pain. The breathing tube in the airway may cause some discomfort. It also affects the ability to talk and eat. If the breathing tube is a trach tube, the person may be able to talk. (A trach tube is put directly into the windpipe through a hole in the front of the neck.)
Instead of food, you may be given nutrients through a vein in your body. If you're on a ventilator for a long time, you'll likely get food through a nasogastric, or 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 activity and also limits movement. You may be able to sit up in bed or in a chair, but you usually can't 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.
Risks Associated with Being on a Ventilator
People on ventilator should be carefully monitored by a health care team, including doctors, nurses, and respiratory therapists. The person may need periodic chest x rays and regular blood tests to check the levels of oxygen and carbon dioxide (blood gases) in the body.
These tests help the health care team find out how well the ventilator is working. 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 the breathing tube from time to time. Suctioning removes mucus from the lungs. It will cause the person to cough. He or she may feel short of breath for several seconds.
Risks of Being on a Ventilator
Being on a ventilator does have some risks associated with it.
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.
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.
Pushing air into the lungs with too much pressure can harm the lungs.
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.
The National Heart, Lung, and Blood Institute (NHLBI) is a research, training, and education program to promote the prevention and treatment of heart, lung, and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives.