What Is a Ventilator and How Does It Work?

A ventilator may be required for short-term routine surgery or more serious respiratory failures. In either case, the term ventilator can raise general fears and concerns. These concerns are based on the need for a mechanical breathing apparatus to support you or your aging loved one. There are many misconceptions about ventilators. The ventilator is a machine and is designed to treat patients by bringing oxygen into the lungs. To prepare you for any surgery or more severe circumstance that requires a ventilator, we answered several important questions below.

Take the time to review this information to be more knowledgeable on the subject and ask your physician to clarify anything that may be confusing or misunderstood.

What is a Ventilator?

In the simplest definition a ventilator is used to help you breathe. The mechanical ventilation (often termed: respirator or breathing machine) is a lifesaving and life-preserving medical device. In routine surgery that requires a ventilator (those under general anesthesia) the medical staff will review what is required, why you will be on it and will monitor your recovery. For non-routine situations, the ventilator will be used for those unable to breath on their own and admitted into the Intensive Care-Unit (ICU) of the hospital.

The ventilator’s (respirator, breathing machine) primary benefits are significant and powerful. The main benefits include, but are not limited to:

  • Getting adequate oxygen
  • Clearing carbon dioxide
  • Helping you not work as hard to breathe
  • Letting respiratory muscles rest
  • Allowing time to recover
  • Preventing injury from aspiration
  • Preserving a stable airway

Why are Ventilators Used?

As the many titles indicate (mechanical ventilator, respirator, breathing machine) the ventilator is used to help you breathe. The three primary reasons a ventilator is used are:

During Surgery - A temporary breathing mechanism for you while under general anesthesia. This is a routine coordination within the operating room. Your surgeon would describe if you would need a ventilator should you need one.

To Help Recover From Surgery - After a surgery some will need additional help breathing. This may be a requirement for hours, days or weeks. This is to support your recovery.

For Urgent Support -  In respiratory failure, which can occur from: pneumonia, chronic obstructive pulmonary disease (COPD—chronic bronchitis, emphysema), acute asthma attack, acute respiratory distress syndrome, or severe viral infections a ventilator may be required and done so under emergency situation for a critically ill individual

The ventilator will reduce the energy required to breath and allow your body to focus on fighting infection or recovering from surgery or an injury. Those will a serious injury to the nervous system will likely need a ventilator, especially those unconscious due to a buildup of toxins or a drug overdose.

How Does a Ventilator Work?

The ventilator brings in oxygen and carries out carbon dioxide to mimic our normal bodily function. In your regular day-to-day you do not even notice your lungs expanding or contracting. When you sprint and feel your body breathing heavier (pulling in more oxygen) you can sense the expansion of your lungs. When you are physically unable or to support your regular body functions a ventilator will bow air (with oxygen) into your airways and then into your lungs. This is often associated with continuous positive airway pressure.

After carrying in oxygen, the ventilator, will carry out carbon dioxide from your lungs. The artificial airway (a hollow tube) goes into your mouth and down your main airway (trachea) to your lungs. The many airways include:

  • Nose and linked air passages, called nasal cavities
  • Mouth or nose
  • Larynx
  • Trachea
  • Bronchial tubes

The process described above is called - Intubation. This is the activity of inserting the hollow tube to your airway. The tube is then connected to the ventilator which pushes and pulls air to-from your lungs. Before your intubated you are likely sedated making your airway relaxed and the tube to be easily inserted.

Risks of Being on a Ventilator

Risks will vary widely for those on a ventilator. Some of the more common risks in the United States include:

  • Trauma to the teeth, mouth, tongue, and/or larynx
  • Accidental intubation in the esophagus (food tube) instead of the trachea (air tube)
  • Trauma to the trachea
  • Bleeding
  • Inability to be weaned from the ventilator, requiring tracheostomy.
  • Aspirating (inhaling) vomit, saliva or other fluids while intubated
  • Pneumonia, if aspiration occurs
  • Sore throat
  • Hoarseness
  • Erosion of soft tissue (with prolonged intubation)

There is a potential higher risk of pneumonia with exposure to any bacteria that enters the breathing tube. This is a challenge that medical staff take extreme precautions to minimize.

How You Can Help Your Aging Loved One

If your aging loved one is concerned or wants to talk about the need to be on a ventilator, it will go a long way to make time for them, share this information and discuss with their physician. Some easy ways to help your aging loved one include:

  • Talk to them! Discuss the benefits, risks and review what the ventilator does.
  • Be present with your aging loved one when on the ventilator. Let them know you will be present and hold their hand if possible.
  • Bring in comfortable clothes to the hospital and other items from home.
  • Create rules for visitors and explain how/when they should visit the hospital or your home

Summary and Main Takeaways

In general, the ventilator is to help you breathe. There are many situations that require the use of a ventilator. Discuss the risk and benefits of using a ventilator with your physician or respiratory therapist about your particular need.