What is mechanical ventilation?
Mechanical ventilation is a treatment to help a person breathe when they find it difficult or are unable to breathe on their own. A mechanical ventilator pushes airflow into the patient’s lungs to help them breathe.
Do you need mechanical ventilation if you have COVID-19 coronavirus?
Mechanical ventilation is part of the arsenal of supportive care clinicians use for COVID-19 coronavirus disease patients with the most severe lung symptoms.
A COVID-19 infection can cause fluids and mucus in the lungs that block oxygenation of lung tissue. Mechanical ventilation can help support COVID-19 patients' breathing until their immune system and treatment can clear the infection and proper lung function is restored.
Public health experts fear there is a shortage of mechanical ventilation machines in the U.S., considering the coronavirus pandemic.
Why is mechanical ventilation required?
Breathing is essential to get oxygen into the body and expel carbon dioxide. The lung normally performs this function by expanding and drawing in air and contracting and expelling it.
The lung has millions of tiny air sacs (alveoli) that transfer the oxygen into the blood supply that flows to the heart and remove the carbon dioxide from the blood flowing into the lungs from the heart. Certain illnesses prevent the lung from functioning normally.
Mechanical ventilation is required when:
- a patient needs assistance with breathing
- the patient’s respiration needs to be mechanically maintained
Mechanical ventilation assists lung function until ventilation is no longer needed. Mechanical ventilation helps in:
- relieving respiratory distress
- decreasing the work of breathing
- improving exchange of gases (oxygen/carbon dioxide)
- healing the lung
- reversing respiratory muscle fatigue
- allowing time for the patient to rest and recover
How is mechanical ventilation performed?
Mechanical ventilation may be performed invasively or noninvasively. Invasive ventilation is performed in the intensive care unit of hospitals. The two invasive methods of mechanical ventilation are:
- Endotracheal intubation: a tube inserted through the patient’s nose or throat.
- Tracheostomy: a tube inserted into a hole made in the patient’s throat.
Beside ventilation, the other benefits of intubation are:
- Bronchoscopy: examining the lung with a bronchoscope inserted through the breathing tube.
- Aspiration: suction of fluids to keep the airway clear.
- Medication: aerosolized medications more effectively delivered directly to the airway or lungs.
Noninvasive ventilation that can be administered at home or in the hospital are of three kinds:
- CPAP: Continuous positive airway pressure that delivers constant and steady air pressure.
- APAP: Autotritating (adjustable) positive airway pressure that changes air pressure according to the breathing pattern.
- BiPAP: Bilevel positive airway pressure that delivers air with different pressures for inhalation and exhalation.
What are the indications for mechanical ventilation?
The indications for starting mechanical ventilation in a patient are
- Abnormally slow breathing (bradypnea)
- Cessation of breathing (apnea)
- Abnormally rapid breathing (tachypnea)
- Inefficient exchange of gases
- Respiratory muscle fatigue
Who needs mechanical ventilation?
Mechanical ventilation is a life-support treatment in the hospitals for critically ill people in acute respiratory distress or failure. Ventilation may be required by patients in conditions that include:
- Short-term ventilation while being under general anesthesia for a surgical procedure.
- Severe heart disease
- Acute lung injury
- Hypotension
- Coma
- Sepsis and multiorgan failure
- Neuromuscular diseases
- Pneumonia
- Acute asthma
- Chronic obstructive pulmonary disease (COPD)
- Acute respiratory distress syndrome (ARDS)
- Bacterial inflammation in the lungs
- Viral infections in the respiratory system such as
Health News
- Huge Mass of Sargassum Seaweed Is Targeting Florida's Coast, With Hazards to Health
- ER-Based Pharmacies Could Improve Kids' Care, Pediatricians' Group Says
- With Training, Soccer Headers Might Be Safe for Teen Players
- Compounds in Chocolate, Berries Might Help Boost Memory As You Age
- Stress Across the Life Span Could Worsen MS
More Health News »
What are the risks and complications of mechanical ventilation?
Mechanical ventilation has a few risks and complications that can sometimes be life-threatening. The complications can arise during intubation or with ventilation.
Complications of intubation
- Upper airway and nasal trauma
- Tooth displacement (avulsion)
- Injury to the mouth, throat, vocal cords or trachea
Prolonged intubation might cause:
- sinusitis
- tracheal narrowing (stenosis) or tissue death (necrosis)
- edema in the vocal cords
- infection in the respiratory system
- pneumonia
- sepsis in the bloodstream
Complications of ventilation
- Ventilator-induced lung injury leading to alveoli rupture and lung collapse (pneumothorax) from:
- Barotrauma – trauma caused by excess air pressure
- Volutrauma -- caused by excess volume of air
- Oxygen toxicity from too much oxygen
- Ventilator-assisted pneumonia caused by bacterial and viral infections in the lung
- Medication side effects and reactions
- Effects on other organs such as
- blood circulation
- heart
- kidneys
- abdomen
- Ventilator malfunction
- Inability to wean off from the ventilator
- Sepsis
- Death
Health Solutions From Our Sponsors
References
Medscape Reference
Complete List
Top Who Needs Mechanical Ventilation Related Articles
COVID-19 Coronavirus Disease: Articles of Interest
Read about COVID-19 Coronavirus Disease. See interesting articles related to vitamins and supplements to boost immunity, symptoms, prevention, vaccines, historical comparisons to past pandemics, and more.
COVID-19 (Coronavirus) Prevention Tips
COVID-19 is a novel coronavirus that spreads from person to person via infected respiratory droplets. The main symptoms of COVID-19 infection include cough, fever, and shortness of breath. Occasionally, people infected with COVID-19 may experience diarrhea, a sore throat, a runny or stuffy nose, or aches and pains. Avoiding contact with infected people, social distancing, not touching your face, frequent hand washing, cleaning, and disinfecting of frequently touched surfaces can help to reduce your risk of contracting the 2019 novel coronavirus.
COVID-19 vs. Flu vs. Cold
When you're feeling sick, it can be difficult to distinguish the symptoms of a COVID-19 infection from the symptoms of the common cold or the flu (influenza). While fever is common with the flu and COVID-19, sneezing is typically only associated with colds. Though sore throats are typical with colds, they are uncommon with COVID-19 infections and the flu.
How Do the COVID-19 Coronavirus Tests Work?
Tests used for detection of SARS-CoV-2 (COVID-19) may use two methods to detect SARS-CoV-2 virus, the cause of COVID-19 disease, a debilitating and potentially deadly viral pneumonia. Genomic or molecular detection confirms the presence of viral DNA. The immunoglobulin or serology tests can tell whether or not you have been exposed to coronavirus, but not whether you are currently infected. Both tests administered in tandem can give you your complete COVID-19 infection status.
How Do You Do CPR On a Newborn?
Neonatal resuscitation (CPR) provides oxygen, stimulates breathing and gets the heart to start pumping normally. Most premature babies and babies with certain congenital conditions require extensive resuscitation.
What Are the Most Common Surgical Airway Techniques?
Surgical airway management involves the creation of an airway using surgical techniques. The four distinct but related most common surgical airway techniques include open cricothyroidotomy, needle cricothyroidotomy with jet oxygenation, percutaneous cricothyroidotomy using the Seldinger technique, and surgical tracheostomy (an incision in the windpipe made to relieve an obstruction to breathing).
What Drugs May Fight COVID-19? Drug Trials, Treatments, Vaccines
What drugs could help fight coronavirus COVID-19? Clinical studies are ongoing for antiviral drugs like hydroxychloroquine, chloroquine remdesivir, lopinavir and favipiravir, as well as COVID-19 vaccines. Learn why anti-flu respiratory drugs and home remedies may prove useful to treat or prevent serious coronavirus infections.
What Is a Laryngeal Mask Airway (LMA) Used For?
A laryngeal mask airway (LMA) is a device inserted into the area behind the mouth and nose, connecting them to the food pipe (the pharynx) to allow ventilation, oxygenation, and administration of anesthetic gases, without the need for inserting a tube in the windpipe (endotracheal intubation). It was initially used mainly in an operating room setting, but is also used in the emergency setting. Complications include aspiration of stomach contents, local irritation, upper airway injuries, mild sympathetic response, obstruction, laryngospasm, pulmonary edema, and bronchoconstriction.
What Is Bag Valve Mask Ventilation (BVM) Used For?
Bag-valve-mask (BVM) or the Ambu bag is a self-inflating bag used to provide ventilation to the person not breathing normally. BVM ventilation is a critical skill for emergency providers. BVM ventilation is a technique that restores breathing in patients who are not spontaneously breathing. BVM ventilation is indicated in the respiratory (lung) failure, failed intubation (insertion of an artificial ventilation tube into the trachea), patients undergoing anesthesia for elective surgery, and apnea (slowed or stopped breathing).
When Should a Tracheostomy Tube Be Changed?
A tracheostomy is an opening that surgeons make through the front of the neck and into the windpipe (trachea). The tracheostomy tube is placed into the opening to keep it open for breathing when the usual route for breathing is somehow blocked or reduced. When health problems require long-term use of a machine (ventilator) to help breathe, a tracheostomy is often needed. In rare cases, an emergency tracheostomy is performed when the airway is suddenly blocked, such as after a severe injury to the face or neck.
Why Would a Newborn Need a Ventilator?
Some babies may have trouble breathing. Respiratory distress or failure may be the result of underdeveloped lungs or a congenital condition. The mechanical ventilator provides oxygen until the baby can breathe unassisted.
COVID-19 (Coronavirus, 2019-nCoV)
Infection with COVID-19 (2019 novel coronavirus, 2019-nCoV) causes respiratory problems in humans. Transmission of COVID-19 occurs mainly through contact with respiratory sections from an infected person, however, fecal contamination may also spread the virus. Symptoms start off flu-like and progress to coughing, fever, shortness of breath, shaking chills, headache, loss of sense of taste and/or smell, muscle pain, and sore throat. Treatment focuses on supportive care and symptom relief. COVID-19 vaccines are available.
Coronavirus COVID-19 (SARS-CoV-2) Pandemic Outbreak: What You Need to Know
A new strain of coronavirus (COVID-19, SARS-CoV-2) was reported from Wuhan, China in December, 2019. This outbreak of respiratory flu-like symptoms has quickly spread resulting in a worldwide pandemic. Learn about symptoms, treatment, prevention and vaccine efforts.
Novel Coronavirus (COVID-19) Prevention Quiz
Why is coronavirus considered dangerous? What are the symptoms you should look for? Take this COVID-19 prevention quiz to learn how to protect yourself.