Artificial Ventilation (Ventilator)

This is an automatically translated article.

The article was written by Doctor Nguyen Ngoc Phuong Nam - Emergency Medicine Doctor, Vinmec Central Park International General Hospital.

Artificial ventilation or mechanical ventilation is a procedure to assist or control breathing in surgical or acute life-threatening situations. The patient needs to use a ventilator to support breathing and airways.

1. Methods of artificial ventilation

Non-invasive artificial ventilation: The patient is assisted with breathing from a ventilator through a breathing "mask". Invasive artificial ventilation: The patient needs to be intubated with a "breathing tube" into the respiratory tract and the ventilator will be connected to the breathing tube to support the patient's breathing.

2. When does the patient need to perform artificial ventilation?

2.1 During Surgery If you have general anesthesia during surgery, you will likely be connected to a ventilator. The drugs used for anesthesia can disrupt normal breathing. The ventilator helps ensure that you continue to breathe during surgery.
However, depending on the type of surgery you have, you may be on the ventilator for a few hours to a few days after the surgery. Most people who have had anesthesia during surgery only need ventilation for a short time.
2.2 For Respiratory Impairment You may need mechanical ventilation (artificial ventilation) in the event of a medical condition, condition, or other factor leading to respiratory failure. Although you can breathe on your own, but find it difficult to breathe, fast breathing, non-invasive artificial ventilation can help improve breathing.
People who cannot breathe on their own must use invasive artificial ventilation to help the respiratory process take place at its best.

2.3 Some medical conditions require mechanical ventilation (artificial ventilation) Severe pneumonia leading to respiratory failure Acute exacerbation of COPD (chronic obstructive pulmonary disease) Severe asthma or some other lung disease causing respiratory failure. Acute pulmonary edema due to heart failure Upper spinal cord injury, paralysis, amyotrophic lateral sclerosis (ALS), myasthenia gravis, and other diseases or factors affecting the nerves and muscles involved in breathing Trauma brain or stroke Drug overdose

3.How to perform artificial ventilation

3.1 Non-invasive artificial ventilation The patient receives respiratory support from the ventilator through a breathing “mask”. A closed mask is placed on the nose - mouth area and connected to a ventilator to help you breathe.
When your respiratory condition improves, the doctors will evaluate you to “wean” the ventilator. And if there is a good improvement, stop the ventilator completely and you will return to breathing naturally.

3.2 Invasive Artificial Ventilation First, the patient will be anesthetized and intubated a “breathing tube” into the trachea.
Then the ventilator will be connected to the endotracheal tube and the ventilator will support the body's respiration to ensure oxygen supply to the body as well as release C02 for the body. You will need to use sedation to get the best controlled “sleep” for the ventilator to work.

When your situation improves, your doctor will evaluate to stop sleeping pills and help you wake up. Based on your medical condition has improved, your doctor will let you practice weaning off the ventilator and then extubate the trachea.

4.Complications and disadvantages of mechanical ventilation

Artificial ventilation is an effective measure to meet the patient's respiratory needs, but it also causes many complications for the patient.
4.1. Injury to lung parenchyma and alveoli Alveolar rupture causing pneumothorax: high pressure of pushing air into the lungs 80-100cm new water ensures air entering the alveoli, which can cause alveolar rupture, especially chronic diseases with available in the lungs such as: Asthma, COPD...
4.2. Cardiovascular Decreased cardiac output: the pressure of pushing air causes the air pressure in the alveoli to increase, leading to a slowing of capillary circulation, a decrease in blood return to the heart, and a decrease in blood flow in the lungs.
In addition, mechanical ventilation will affect the function of the heart, leading to a decrease in the function of the heart.

4.3. Vocal cord problems When doctors remove a breathing tube from a patient, their vocal cords can be damaged. Initially, the patient will feel sore throat and have a hoarse voice. So talk to your doctor if you feel short of breath or have trouble talking after the tube is removed.
4.4. Other complications Digestive disorders: abdominal distension, intestinal paralysis, constipation due to lying down for a long time. Urinary disorders: due to decreased renal perfusion, inhibition of sodium excretion, decreased clearance leading to systemic blood stasis. Pressure ulcers: due to anesthesia, long-term mechanical ventilation is the main cause of pressure ulcers in the sacrum, the heels.. Infections: Patients on ventilators are often in a serious condition, are performed many times. techniques such as: endotracheal intubation, tracheostomy, subclavian vein placement, urinary catheterization, gastrostomy, infusion techniques, etc. are susceptible to hospital-acquired infections. Change in mental status: due to the nature of the disease and due to the intervention of many techniques, long treatment time,... Mechanical ventilation is an intervention method to control breathing that is critical, vital, help treat serious illnesses to help save lives. But through that, there are also many disadvantages surrounding mechanical ventilation, especially serious diseases requiring long-term mechanical ventilation.
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