Invasive ventilation therapy is a well-established treatment modality. It’s a type of life support meant to assume breathing responsibility in patients who can’t breathe well enough on their own.
Also referred to as a ventilator, breathing machine, or respirator, mechanical ventilation can help with severe breathlessness and plummeting oxygen levels. Plenty of reasons can make someone rely on a ventilator. Whether that is pneumonia or any other ailment.
Recently, the number of patients on mechanical ventilation has skyrocketed. COVID-19 led to an increasing need for this type of therapy. Here is a quick look at what this therapy has to offer.
What Is Invasive Ventilatory Support?
Invasive or mechanical ventilation is positive pressure supplied to the lungs. Doctors use a tracheostomy or endotracheal tube to get the desired result. This type of support is the most typically used technique in intensive care units (ICUs).
This mechanical support is meant to blow air into the lungs. Without it, patients could die in a couple of hours to days from hypercapnic and hypoxaemic respiratory failure. Depending on what the individual is dealing with, they may receive endotracheal intubation or tracheostomy. These are the different invasive ventilation types.
With tracheostomy, doctors make a hole into the airway and insert a tube. While with endotracheal intubation, the tube goes into the trachea (airway) either through the nose or mouth. A medical care expert will determine which is the best approach.
Why Is Invasive Ventilation Needed?
Patients in need of ventilatory support typically develop a pattern of physical deterioration. This pattern indicates a clear need for invasive ventilation. The classic indications for invasive ventilation include:
- Losing consciousness
- Respiratory distress
- Problems with gas exchange (carbon dioxide or oxygen)
- Frequent oxygen desaturation despite the boost in oxygen concentration
- Increased respiration rate
- Need to reverse respiratory muscle fatigue
- Need to take the load off when breathing
Invasive ventilatory support can come in handy when a patient must receive high oxygen concentration. Or, they are having trouble removing the carbon dioxide from their system. By relying on this kind of support, the body focuses on healing or fighting the infection, rather than struggling to breathe.
What Is Invasive Ventilation COVID?
In severe cases, particularly those who experience serious hypoxaemia and respiratory failure, it may be necessary to rely on invasive ventilation for COVID-19. The pneumonia the coronavirus causes, takes hold of both lungs.
The air sacs are quickly filling with fluid, which makes it downright taxing for the body to take in more oxygen. That’s why a lot of patients have trouble breathing and need help to support the airflow. The ventilator is here to provide that necessary support and get the recovery process back on track.
How Long Is Mechanical Ventilation Used?
This type of support can save a person’s life. Although it can’t fix the problem that led to the ventilation in the first place, it gives people a chance to recuperate and survive. With the right support, treatments are more effective.
Some people might need a ventilator for a couple of hours to a few days. Others will use it much longer. It will vary based on what’s causing the breathing problem. As soon as the body is capable of breathing on its own, then doctors will take out the ventilator. This is called “weaning”.
One research evaluated how long patients rely on mechanical ventilation in the emergency department. They enrolled 535 patients. Most (38.3%) received intubation because of their altered state of mind without respiratory disease.
About 23.2% required breathing support due to trauma, and 17.1% from respiratory failure. Based on the results, the average duration of mechanical ventilation was 4 hours and 28 minutes. But, some patients needed to rely on a ventilator much longer.
Factors that affect how long a patient stays on mechanical ventilation include overall strength. Like how well the lungs are doing and how many organs are affected. Such as the kidneys, heart, or brain.
Is Invasive or Non-Invasive Ventilation (NIV) Better?
NIV offers better outcomes than mechanical ventilation. Mainly when used as an initial treatment option in people with acute complications of COPD. Non-invasive therapy is a more practical, comfortable, and cost-effective solution.
But, invasive ventilation sometimes becomes an essential tool for survival. It is required by patients with serious heart disease, neuromuscular disease, or pneumonia. It’s also used in case of an acute lung injury, coma, sepsis, or acute asthma. Only a health care expert can decide which one would suit your needs.
Is Invasive Ventilation Painful?
People are asking “do they sedate you for intubation”? Unless the person has already lost consciousness or has a rare ailment that can’t tolerate sedation, patients tend to get sedated. Meds used for tracheal intubation are induction agents (sedatives), pre-treatment meds (i.e. opioids, defasciculating agents, etc), or paralytics.
Being intubated can be a traumatic, painful, and uncomfortable experience, despite the use of analgesics and sedatives. Patients can’t communicate with their nurses, which puts a heavy toll on their mental well-being. But, nurses are trained in evaluating the patient’s health state and offer maximum comfort. While being intubated, you can experience discomfort.
The reason why intubated patients can’t talk is that the tube passes between their vocal cords until it reaches the windpipe. While the tube is still inside the body, patients can’t eat by mouth. Also, the air that is pushed into the lungs can feel slightly uncomfortable.
This is normal, considering the body isn’t used to invasive mechanical ventilation. To curb the unease and aches, people receive pain controllers or sedatives. These meds are meant to make the process a lot more comfortable. But, they can also make you feel drowsy or sleepy.
Who Takes Care of a Mechanically Ventilated Patient?
Healthcare experts have special training in how to handle mechanical ventilation. A physician, usually a pulmonologist, anesthesiologist, or intensivist will take care of the patient on a regular basis. When writing orders for therapy, doctors can be accompanied by a registered nurse or a nurse practitioner.
If there is a need to examine the condition or change the treatment, particularly when dealing with breathing (respiratory) disease, then a respiratory therapist will evaluate the patient’s airways. This is to ensure that those affected are recuperating properly.
Possible Risks
Just like any treatment modality, mechanical ventilation also has its drawbacks. There is a possibility for sore throat, dental damage, and inner cheek cuts. Some patients may also have trouble talking after weaning. In certain cases, there could be a pain in the lungs or aspiration.
Aspiration happens when the patient inhales blood, vomit, or other secretions. To curb the possibility of risks, it is important to mitigate the risk factors that can lead to intubation complications.
These include smoking, obesity, poor oral health, and unmanaged lung disease. Patients are advised to talk to family members or a doctor about their current health state and lifestyle choices. This can help mitigate the risks to a certain extent.
