A medical ventilator can save someone’s life. It can help a patient breathe properly when their body can’t take in oxygen on its own. Often considered a go-to choice among patients with lung complications and various diseases, these medical devices can get oxygen into the lungs and remove carbon dioxide from the body.
Because of the COVID-19 pandemic, the use of medical ventilators has skyrocketed. This device has become a vital treatment in seriously ill patients. Since these machines are now in the spotlight, very few people realize how they work or what they do. So, when it is time to start the weaning process, they have no clue what to expect.
That’s where this simple guide will come in handy. Here is a quick overview of how weaning from the ventilator looks like. As well as how the machine works and affects the body.
What Is a Medical Ventilator?
When a patient is unable to breathe on their own, they will need a medical ventilator to boost their breathing insufficiency. A ventilator is a machine mostly used in emergency medicine, intensive care, and home-care settings.
Often referred to as respirators, these products feature a compressible air turbine or reservoir, paired with valves, tubes, oxygen supplies, and a disposable patient circuit. The machine will push moist and warm air into the patient’s lungs and exhale the air for them. Therefore keeping the lungs in shape.
While still on a ventilator, the doctor will carefully monitor the patient’s respiratory and heart rates. Including their oxygen saturation, and blood pressure. Experts can also recommend blood draws and X-rays to determine the carbon dioxide and oxygen levels.
Weaning from Ventilator – What Does It Mean?
The term “weaning” is meant to describe the slow and gradual process of reducing ventilator support. According to experts, 40% of the duration of mechanical ventilation is focused on the weaning process.
Weaning from the ventilator is classified into three types based on the weaning duration. You have:
- Simple weaning – ventilator has been removed after the first assessment.
- Difficult weaning – ventilator has been removed 2 to 7 days after the first assessment.
- Prolonged weaning – ventilator has been removed 7 or more days after the first assessment.
Before weaning, the patient must go through a spontaneous breathing trial (SBT) capable of assessing their ability to breathe without or with minimal ventilator support. For the doctor to remove the ventilator, it is important to assess the patient’s health state and see whether the respiratory failure has been resolved.
Usually, the doctor will rely on a combination of objective and subjective criteria to evaluate if the patient is ready for weaning. They can see whether the patient has a better mental status, gas exchange, radiographic signs, and neuromuscular functional assessment.
Only certified experts can determine the best time for weaning from the ventilator. The healthcare team is often composed of a respiratory therapist, pulmonologist, anesthesiologist, intensivist, and an ICU when it is time for weaning.
Weaning Success Rates
Key Points
- SBT and daily respiratory function screening can speed up the weaning process.
- Patients who accidentally remove their endotracheal tube have a 31% to 78% risk of reintubation.
- SIMV (Synchronized intermittent mandatory ventilation) is the least effective weaning method.
Many people wonder if it is hard to wean someone off a ventilator. The truth is, 20% of patients who need mechanical ventilation suffer from trouble weaning. Since they might have experienced more serious lung damage, it can be difficult to wean them off a ventilator.
According to an observational study from the National Library of Medicine, the overall survival rate from prolonged mechanical ventilation was 62%. About 56% of 1307 patients were successfully weaned. So, why is it so difficult to wean off a ventilator?
Experts estimate that difficulty in weaning comes from intrinsic lung diseases or a prolonged serious illness. After a patient has suffered from a serious disease that puts their lives in danger, the weaning failure incidence can vary with 20% of all patient admissions failing the first weaning process.
The average time for liberating a patient from a ventilator will depend on how serious their disease or injury is. Most people need from 16 days to 37 days after intubation. Doctors will determine the exact impact weaning can have on their body.
If you are capable of breathing on your own after the machine has been removed, then you can recover later on.
Is Weaning from a Ventilator Painful?
Being on a ventilator may not be the most comfortable part of your recovery process. But, it is a critical life-saving system. Since the body will rely on the machine to function normally, being intubated can feel restricting.
Even though patients are often sedated after receiving a medical ventilator, they can still feel some of the air from the tube being pushed into the lungs. This can cause some level of discomfort. The removal process can also be unpleasant. But, with the help of skilled professionals, you could get your breathing back on track.
Final Thoughts
Ventilators are crucial breathing devices that allow the lungs to function normally. Even though they can’t fix or treat a certain problem, they can give your body oxygen support, so that it can heal and function properly. Weaning from a mechanical ventilator is a process of decreasing ventilator support in patients, giving them their independence back and breathing spontaneity. This process takes careful preparation and planning. A team of experts will work on your breathing problems until you can regain that independence.
References
https://www.healthline.com/health/ventilator#definition
https://www.yalemedicine.org/news/ventilators-covid-19
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893753/
https://academic.oup.com/bjaed/article/5/4/113/475175
https://www.ncbi.nlm.nih.gov/books/NBK430712/
https://litfl.com/difficulty-weaning-from-mechanical-ventilation/
https://www.medscape.com/viewarticle/730317
https://pubmed.ncbi.nlm.nih.gov/19359156/
https://thorax.bmj.com/content/57/11/986
https://www.statista.com/statistics/1122713/current-ventilators-and-additional-number-required-select-countries/
