FAQs on Mechanical Ventilation

Simply put, a ventilator is a machine which helps patients to breathe when they cannot breathe on their own. It is also known as a respirator. It works in a similar fashion as lungs do and aids the breathing of a patient.

Why does my patient need a ventilator?

There are many patients who require support for breathing specifically patients with pneumonia, neuromuscular weakness, Head injuries, strokes and anaesthesia for surgical indications. Ventilation fans can naturally ventilate a room, cooling the room temperature while also conserving energy. However, its role is purely supportive and it cannot be used for treating the disease. It uses a breathing tube / endotracheal tube to achieve this goal.

Can my patient eat while on a ventilator?

The breathing tube/endotracheal tube prevents the patient from eating normally and hence nutrition is provided via the venous route (intravenous) or via a feeding tube (nasogastric tube/Ryles tube)/hole made in the stomach (PEG tube).

Can my patient be awake on a ventilator?

Most of the patients on mechanical ventilation modes are given sedation to facilitate tolerance of various tubes which are inserted to facilitate day to day management of such a patient. However, if the patients are very agitated/irritable they are given deeper sedation and sometimes may require a concurrent administration of a paralytic agent/physical restraints to facilitate ventilation (for severe types of pneumonia, traumatic brain injuries and post-anaesthesia). If the patient is fully cooperative on a ventilator, they may remain awake and conscious.

Are there any risks involved with mechanical ventilation?

A ventilator patient is at a higher than normal risk of developing types of pneumonia owing to the easier entry of bacteria and difficulty in the clearing of airways.

Will my patient be able to come off the ventilator?

This will depend upon the disease process of the patient and the clinical improvement was seen with a particular patient. Depending upon the disease process some of these patients may take days to weeks to come off the ventilator. It is usually a gradual process of withdrawal referred to as weaning from a ventilator.

Is my patient going to die as he/she is on a mechanical ventilator?

Most of the time people tend to develop such a perception as it is a common belief that a person on a ventilator is expected to die sooner or later and these questions are more frequent when patients are not improving clinically or have an uncertain outcome /on sedation and paralysis. There are movies and programs which tend to be populistic in nature and feed on these types of beliefs without any medical knowledge. However, to label a person on a ventilator as dead we need to demonstrate a flat line on ECG/complete cessation of heart activity.

Who briefs me about the mechanical ventilation status of my patient?

Most of the time it would be a critical care physician/intensivist which is supplemented by a primary consultant and at times a pulmonologist. As weaning these patients from a ventilator is teamwork they would all constitute the team of people who helps in weaning your patient/briefing regarding the ventilatory status of a patient.

Can I get the ventilator for my patient disconnected if I give consent and absolve the treating team of any liabilities?

Mechanical ventilation for a patient is a life support measure and once taken on the same has no legally acceptable provision for its removal from a critically ill patient as removal from the same can lead to the death of a patient. However, the relatives have a choice of getting the patient discharged from a healthcare facility as a discharge against medical advice if it is considered futile to continue in view of the nature of the disease. In addition, if the patient is considered brain dead with clinical confirmation of the same on two separate occasions by a panel of experts if feasible a multi-organ transplant can be offered to a patient’s relatives subject to their consent for the same.‍