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When is a Mechanical Ventilator Necessary?

By Erin J. Hill
Updated May 17, 2024
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When a patient cannot breathe on his own, a mechanical ventilator may become necessary. Disease and injury are primary reasons for patient ventilation, as well as certain treatments used for these conditions, like surgery. Generally the ventilator is meant for short-term use, although some patients may require extended intubation if the lungs fail to improve or worsen.

Injury is one reason a patient may need a mechanical ventilator. Automobile accidents, falls and wounds inflicted by gunshots or knives may result in injuries directly to the lungs or in the surrounding areas, leaving the patient struggling for breath. In these situations ventilation becomes necessary until the wounds have healed and the patient can once again breath on his own.

Many illnesses also result in the use of a mechanical ventilator. A host of lung disorders and heart issues can cause a patient to suffer respiratory failure. In some cases, the patient may not feel any lack of oxygen directly, but a blood test may reveal that blood oxygen levels are low and need assistance in returning to normal. Ventilation is generally necessary until the cause of the issue is resolved. In some cases, the disease may not be treatable or may be slow to heal. This can result in the long-term use of the mechanical ventilator until further actions can be taken or the patient passes.

Premature infants also frequently need a mechanical ventilator to help them breath for the first days or weeks of life. An infant who is born before the lungs have fully matured may not have the ability to breathe entirely on his own, making ventilation necessary until the lungs have time to catch up. Sometimes steroids or other lung maturing agents may be administered, and the infant can be taken off the ventilator within a short period. If additional problems arise like infection, however, the ventilator may be needed until those issues are resolved.

Another primary use for a mechanical ventilator is during surgery. Patients who are put under anesthesia do not have the capacity or ability to take a breath independently while the drugs are being administered. A ventilator is used during the operation, as well as for a short while after to allow the drug to wear off and for normal breathing to become possible.

Mechanical ventilators are inserted by placing a tube down the throat and directly into the wind pipe. This is the small “tunnel” leading from the mouth and nose down to the lungs. The ventilator is then attached to the tube and works by sending oxygen through the tubing and then removing carbon dioxide as it “breathes” back out.

There are some risk factors involved with using a mechanical ventilator. In lungs that are very weak or injured, the pressure of the ventilator may cause further damage or strain. The tubing used to connect the ventilator may also cause damage to an irritated or injured esophagus and should be inserted with care. Removal or gradual weaning from the ventilator is recommended as soon as it becomes an option.

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