You may be put on a mechanical ventilator, also known as a breathing machine, if a condition makes it very difficult for you to breathe or get enough oxygen into your blood. This condition is called respiratory failure. Mechanical ventilators are machines that act as bellows to move air in and out of your lungs. Your respiratory therapist and doctor set the ventilator to control how often it pushes air into your lungs and how much air you get.
You may be fitted with a mask to get air from the ventilator into your lungs. Or you may need a breathing tube if your breathing problem is more serious. When you’re ready to be taken off the ventilator, your healthcare team will “wean” you or decrease the ventilator support until you can start breathing on your own.
Mechanical ventilators are mainly used in hospitals and in transport systems such as ambulances and MEDEVAC air transport etc. In some cases, they can be used at home, if the illness is long term and the caregivers at home receive training and have adequate nursing and other resources in the home. Being on a ventilator may make you more susceptible to pneumonia, damage to your vocal cords, or other risks or problems.
Who Needs a Ventilator
You may need a ventilator in an emergency if a condition makes it difficult to breathe on your own (called respiratory failure). You may also need a ventilator during surgery.
Respiratory failure can be a life-threatening emergency. When you can’t breathe well, your organs cannot get enough oxygen to work. Sometimes, too much carbon dioxide, a waste gas from your body’s cells, can build up in your blood. This needs to be breathed out.
Many conditions and injuries can affect your breathing. Examples include:
- Acute respiratory distress syndrome (ARDS)
- Head injury or stroke
- COPD (chronic obstructive pulmonary disease) or other lung diseases
- Cardiac arrest
- Drug overdose
- Neonatal respiratory distress syndrome, which is a breathing problem that can affect newborns, especially premature babies
- sepsis, which is an infection in your bloodstream
- Spinal cord injuries, polio, amyotrophic lateral sclerosis (ALS), myasthenia gravis, and other diseases that affect the nerves and muscles involved in breathing
You may need a ventilator if you are going to have surgery with general anesthesia (medicine that makes you sleepy and stops you from feeling pain). The medicines used for anesthesia can affect your normal breathing. A ventilator helps control your breathing.
A ventilator may be necessary to help you breathe on your own. Being placed on a ventilator can raise your risk of infection such as pneumonia or other problems.
One of the most serious and common risks of being on a ventilator is developing pneumonia. The breathing tube makes it hard for you to cough. Coughing helps clear your airways of germs that can cause infections. The breathing tube that is put into your airway can allow bacteria and viruses to enter your lungs and, as a result, cause pneumonia.
Pneumonia is a major concern because people who need to be placed on ventilators are often already very sick. Pneumonia may make it harder to treat your other disease or condition. You may need special antibiotics, as the bacteria that caused your pneumonia could be resistant to standard antibiotics.
Another risk of being on a ventilator is a sinus infection. This type of infection is more common in people who have endotracheal tubes. Sinus infections are treated with antibiotics.
Being placed on a ventilator can raise your risk for other problems.
- Atelectasis is a condition in which your lung or parts of it do not expand fully. This causes the air sacs to collapse and reduces the amount of oxygen that reaches your blood.
- Blood clots and skin breakdown can happen from staying in one position for long periods. When using a ventilator, you may need to stay in bed or use a wheelchair. This raises your risk of blood clots, serious wounds on your skin called bedsores, and infections.
- Fluid can build up in the air sacs inside your lungs, which are usually filled with air. This is called pulmonary edema.
- Lung damage can result from pushing too much air into your lungs or using too much pressure. Too much oxygen can also damage your lungs. Babies put on a ventilator, especially premature infants, may be at a higher risk of lung damage from excess oxygen therapy and lung infections in childhood and adulthood.
- Pneumothorax is a condition that develops when air leaks out of your lungs and into the space between the lungs and the chest wall, and sometimes into the muscles and tissues of your chest wall and neck. This leakage can cause pain and shortness of breath. It may cause one or both lungs to collapse. The air that enters the chest could also put pressure on your heart, resulting in a life-threatening situation that would require immediate placement of a tube in your chest to drain the air and decrease the pressure on your heart.
- Vocal cord damage from the breathing tube can damage your vocal cords. This can affect the passage of air into the lungs, especially in young children with smaller airways. Tell your doctor if you experience hoarseness or have trouble speaking or breathing after your breathing tube is removed.
- Weak diaphragm and other breathing muscles from long-term use of a ventilator can lead to some problems and delays in being taken off the machine.