“Venting someone” in a medical setting refers to initiating mechanical ventilation, a form of life support. This procedure uses a specialized machine called a ventilator to assist or completely take over the work of breathing for a patient. The ventilator moves air into and out of the lungs, ensuring the body maintains adequate oxygen levels and successfully removes carbon dioxide. Ventilation is a supportive measure, buying time for the patient to recover from the underlying illness or injury causing the breathing difficulty.
When Breathing Support Is Required
A patient requires mechanical ventilation when the body can no longer sustain necessary gas exchange, a condition known as respiratory failure. This failure manifests as dangerously low blood oxygen (hypoxemia) or an inability to expel carbon dioxide, leading to an acid buildup. Common scenarios necessitating this intervention include severe respiratory illnesses like acute respiratory distress syndrome (ARDS) or widespread pneumonia, which reduce the lungs’ ability to function.
Neurological impairments, such as those caused by a stroke, severe head injury, or drug overdose, can also suppress the drive to breathe. Furthermore, ventilation is routinely used during major surgery requiring general anesthesia because medications often temporarily suppress the patient’s ability to breathe. By taking over the breathing process, the ventilator allows the patient’s respiratory muscles to rest, freeing up energy to focus on healing.
How Mechanical Ventilation Works
Modern ventilators function on the principle of positive pressure ventilation, which is fundamentally different from normal breathing. Normal breathing uses negative pressure created by the diaphragm to pull air in. In contrast, the ventilator actively pushes a controlled mixture of air and oxygen into the lungs, using positive pressure to inflate them.
The machine regulates several parameters to match the patient’s needs. The respiratory rate is the number of breaths delivered per minute. The tidal volume is the precise amount of air delivered with each breath, set to prevent over-inflation or under-inflation of lung tissue. Another element is Positive End-Expiratory Pressure (PEEP), a constant, low level of pressure maintained in the airways after the patient exhales. PEEP prevents the small air sacs (alveoli) from collapsing completely, maximizing oxygen absorption into the bloodstream.
Starting and Stopping Ventilation
To begin invasive mechanical ventilation, a trained healthcare provider must first perform intubation. This involves inserting a flexible endotracheal tube through the mouth or nose and down into the trachea (windpipe). This tube creates a secure pathway connecting the ventilator circuit directly to the patient’s lungs. Because the tube is uncomfortable and can trigger a gag reflex, patients are typically given sedatives to keep them relaxed while the machine breathes for them.
The goal of ventilation is temporary support, and disconnecting the patient is known as weaning. Weaning involves gradually reducing the machine’s support, allowing the patient to take on more of the work of breathing. If the patient successfully demonstrates adequate oxygenation and carbon dioxide removal, the endotracheal tube is removed in a procedure called extubation. This phase is a crucial step in recovery and often represents a significant challenge back to independent breathing.