What is a Ventilator?

A ventilator is a medical device that is used to support people who are having trouble breathing or are unable to do it on their own. Essentially, a mechanical ventilator helps the patient complete a full cycle of breathing, from inhaling to exhaling.

Generally, patients stay on the ventilator until they can breathe normally on their own. This means that they do not need to do any physical work themselves while recovering from whatever is affecting their lungs.

Ventilators, which are sometimes known as life-support machines, are an important medical tool. And, they have become essential in our fight against the Covid-19 pandemic.

How does a ventilator work?

When a person is breathing normally, their chest expands, creating a negative pressure in the lungs that forces air inside. Then the oxygen from the air is used up, and the carbon dioxide is exhaled out.

If someone is ill or weak and can’t expand their lungs to draw in air on their own, a mechanical ventilator is used to pump air into the lungs. It does this by creating a positive pressure that forces air to be sucked into the body.

A hollow tube, called an endotracheal tube, is placed into the mouth or nose (and then into the windpipe) and connects the person to the machine. This is called intubation.
The tube is then used to blow air into the lungs, either helping with breathing or do all of it, depending on the patient’s condition.

Ventilators are generally found in intensive care units (ICUs). While a patient is put on a ventilator, doctors will monitor their heart rate and oxygen saturation levels using a pulse oximeter. They will also check respiratory rates, blood pressure, and oxygen and carbon dioxide levels among other tests.

When is this required?

As we have seen, a ventilator is used by doctors when a person cannot breathe adequately on their own. This can occur with a number of medical conditions that affect lung function— whether due to injury or an illness, such as:

Collapsed lungs
Chronic obstructive pulmonary disease (COPD)
Pneumonia
Brain injuries
Comas
Strokes
Polio
ALS (Amyotrophic Lateral Sclerosis, also commonly known as Lou Gerhig’s disease)
Covid-19

Ventilators may also be used during surgery or while recovering from surgery.

Doctors will be able to tell how long a person needs to be on a ventilator – this can range from a few hours to a few weeks or even longer.

Types of ventilators

There are many types of ventilators with different levels of support. Doctors will choose the type based on the person’s condition.

Manual resuscitator bags – a clear rubber bag (also called an Artificial Manual Breathing Unit, or “Ambu bag”) that is manually squeezed to force air into the lungs.
Face mask ventilators – this is a non-invasive method that involves wearing a mask that fits over the nose and mouth. It is connected to a machine that blows into the airways and lungs.
Mechanical ventilators – these are machines connected to a tube that is placed into a person’s throat. The machine then pumps air into the lungs and takes carbon dioxide away. It can be used to take over the breathing process entirely, and to regulate the pressure, humidity, and temperature of the air being used.
Tracheostomy ventilators – a tracheostomy is a procedure where a doctor makes a cut to create a direct opening to the windpipe. In such cases, this type of ventilator is used that can be directly inserted into the windpipe.

What are the benefits of using a ventilator?

Mechanical ventilators can be life-saving and have a lot of benefits for patients, such as:

Helping patients to do the work of breathing, which in turn lets the respiratory muscles rest and recover.
It gives patients who have trouble breathing adequate amounts of oxygen.
Keeps patients stable so that other medications and treatments can work better.
Ensures that the patient has adequate ventilation by removing carbon dioxide from the body.

However, it is important to remember that mechanical ventilators won’t cure an illness or completely heal a medical condition. Instead, they can keep patients alive and stabilized while doctors use other treatments to fight an infection or help them heal from an injury.

What are the risks of being on a ventilator?

While being on a mechanical ventilator has many benefits, it also has a few risks associated with it. These might include:

Infection – the breathing tube of a ventilator can let germs into your lungs, increasing the risk of getting pneumonia, known as Ventilator-Associated Pneumonia (VAP).
Irritation – the tube can also rub against the throat or lungs, causing irritation.
Lung injuries – prolonged use of a ventilator can cause lung damage. This is caused due to things like too much pressure in the lungs, air leaking outside the lungs (pneumothorax), oxygen toxicity (too much oxygen in the lungs), and in very few cases lungs collapse due to too much air pressure.
Vocal cord issues – the breathing tube passes the voice box or larynx, which can sometimes damage the vocal cords.

Additionally, ventilation requires the patient to be prone (or lying down) at all times, and this lack of movement can lead to other issues. These things like muscle weakness, or bedsores, can take months to recover from.

How do ventilators help people with Covid-19?

Ventilators have become an essential tool in the fight against Covid-19.

While mild symptoms of Covid-19 might include a fever, cough, and sore throat, more serious cases experience difficulty breathing, or develop acute respiratory distress syndrome (ARDS). ARDS can make portions of the lungs unusable, which can lead to several complications.

Thus, patients are put on a ventilator to help them breathe.

Ventilators are used to support a person’s breathing when they experience respiratory failure. They can be life-saving tools and an important part of treatment for a number of conditions, including Covid-19.

However, while they can’t treat or fix a health condition, they can take away the burden of breathing work while the patient is given treatment or is recovering.