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Ventilators are one of the most common tools in critical care, often seen in Intensive Care Units (ICUs). Healthcare professionals use ventilators to perform the work of breathing for patients who have difficulty breathing on their own. When a person cannot breathe effectively, doctors and nurses will evaluate the patient’s airway, lungs, and heart to determine whether a ventilator is necessary. A severe illness or injury can affect the ability to breathe and lead to respiratory failure. That critically ill patient will require mechanical ventilation to support their breathing.
Nowadays, ventilators work using positive pressure ventilation, which provides inspiratory pressure by creating continuous airflow into a patient’s lungs. This is in contrast to negative pressure ventilation, which is how the old-fashioned iron lung functioned.
The two main types of ventilators are invasive and noninvasive. Invasive ventilators go into your lungs through an endotracheal tube (ETT); noninvasive ones don’t require an ETT but still provide assisted breathing by helping you inhale and exhale more efficiently. A respiratory therapist will evaluate the patient’s condition and determine the best option.
Common causes of respiratory failure include pneumonia, sepsis, heart failure, and traumatic injuries. Other possible reasons for respiratory failure include:
- Anaphylaxis: a severe allergic reaction that can cause swelling of the airways.
- Asthma: a chronic condition where the airways become inflamed and narrow.
- Emphysema: caused by damage to the walls of the alveolar sacs, resulting in less elasticity in these areas and making it difficult for oxygen to travel from the lungs into the bloodstream.
Non-Invasive Ventilation
Non-invasive ventilation assists a patient’s breathing through a face mask or helmet that fits over their mouth and nose.
Foam mattresses, pillows, and blankets prop up patients’ heads during non-invasive ventilation, preventing them from developing pressure sores and allowing air to be directed into the lungs more efficiently. Non-invasive ventilation is usually reserved for patients who can breathe on their own but cannot maintain an adequate level of oxygen in their blood. It is often used when patients need supplemental oxygen at night but do not want a face mask attached all day long.
Invasive Ventilation
Invasive ventilation means placing a tube through the mouth and into the airway or trachea to supply air directly to the patient’s lungs, a process known as intubation.
The tube connects to a ventilator, which helps provide oxygen to your blood. The ventilator connects to a machine that measures the patient’s blood pressure, respiratory rate, and amount of oxygen in the blood.
Tracheostomy
A tracheostomy is a procedure that creates a hole in the windpipe to allow for an endotracheal tube. It’s used for those expected to be on a ventilator for a long period of time and patients with neuromuscular disease or injury that has affected the diaphragm.
When a patient cannot adequately exchange carbon dioxide for oxygen on their own, that patient will suffer from hypoxia, which means there are low levels of oxygen in the blood. This can lead to severe side effects and even death if not treated quickly.
Ventilator Modes
There are usually three ventilator settings that the respiratory clinician will select from when providing ventilatory therapy to a patient:
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- Volume Controlled: A pre-set volume of air delivered to the patient’s lungs.
- Pressure Controlled: The patient receives air until it reaches a certain pressure.
- Dual Control: Both options are used in conjunction.
The Difference Between Ventilators and CPAP Devices
Patients with comorbid conditions such as obesity, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS) are more likely to need respiratory support. For example, a person with severe COPD may have difficulty receiving oxygen under normal breathing conditions. In this case, a continuous positive airway pressure (CPAP) device may be necessary to help them breathe effectively.
CPAP devices are not intended for critical care situations because they do not generate the level of pressure that ventilators create. Even bi-level CPAP machines, called BiPAPs, which have a high-pressure setting for inhalation, can’t match the pressure of a ventilator.
CPAP machines also do not have the level of control over air volume and flow rate as ventilators. Ventilators typically allow respiratory therapists and healthcare providers precise control to suit patient needs.
Ventilators: Essential to Saving Lives
Ventilators are necessary to treat a variety of respiratory conditions. You’ll find many types of ventilator accessories at Penn Care, as well as ambulances, first aid, and diagnostic equipment.
