A medical ventilator is a life-sustaining device that supports a patient’s breathing during severe respiratory illness. They manage oxygen intake and carbon dioxide removal when the lungs are overwhelmed. While they do not treat the underlying illness, ventilators provide the necessary support to stabilize a patient, allowing their body time to recover. This technology is used in intensive care, serving as a temporary bridge during acute respiratory distress.
How Ventilators Support Breathing
A ventilator assists or takes over a patient’s breathing. It pushes oxygen-enriched air into the lungs through a tube, mimicking natural inhalation to ensure oxygen reaches the bloodstream. It then facilitates exhalation, removing carbon dioxide. This maintains pressure in the lungs, preventing alveoli from collapsing. Healthcare professionals, including doctors and respiratory therapists, adjust settings like air pressure, volume, and temperature to meet patient needs and manage oxygen levels.
When Ventilators are Needed for COVID-19
Severe COVID-19 can lead to acute respiratory distress syndrome (ARDS), where fluid buildup in the lungs hinders oxygen and carbon dioxide exchange. Inflammation and fluid clog air sacs and stiffen lungs. When oxygen levels drop dangerously low or breathing effort becomes unsustainable, a ventilator is often employed.
Ventilators provide high oxygen and positive pressure, reducing breathing effort. This support allows lungs to heal from severe COVID-19 infection and inflammation. While strategies like high-flow nasal oxygen or non-invasive ventilation may be tried, mechanical ventilation is often a last resort for the most severely ill.
Patient Experience and Care
Patients receive medication to induce unconsciousness before an endotracheal tube is inserted into the windpipe. The tube connects to the ventilator, delivering oxygen-rich air. Light to deep sedation is often necessary to ensure comfort and prevent patients from fighting the machine or attempting to remove the tube.
Constant monitoring by ICU medical staff, including nurses, respiratory therapists, and physicians, is standard. Ventilation duration for severe COVID-19 varies, from 10 to 17 days, or sometimes weeks to months. Weaning involves gradually reducing support as respiratory function improves, a process that can take days or longer with careful assessment of independent breathing.
Potential Medical Considerations
Prolonged mechanical ventilation presents medical challenges. A common pulmonary consideration is ventilator-associated pneumonia (VAP), an infection from the breathing tube providing a pathway for bacteria into the lungs. Studies suggest higher VAP incidence in COVID-19 patients on ventilators compared to other populations.
Another consideration is ventilator-induced lung injury from excessive pressure or volume. Healthcare teams use lung-protective ventilation strategies, like low tidal volumes, to mitigate this. Patients may also experience muscle weakness, known as ICU-acquired weakness, due to immobility and prolonged sedation. Medical teams work to prevent and manage these occurrences through careful ventilator settings, infection control, and early rehabilitation.