Read about what the ventilator is, why a patient may need the ventilator and how the medical team decides if a patient can come off of the ventilator.

The ventilator is a type of life support device that assists a patient’s breathing. Typically, a patient is placed on a ventilator when they experience failure of their lungs. In these situations, the patient may have low oxygen levels or signs they are not ventilating properly. The patient may also need the ventilator when their breathing muscles or the breathing center in the brain fails. The ventilator supports the patient’s work of breathing, oxygen levels, and carbon dioxide elimination. It also makes sure the patient breathes enough times each minute, if they are unable to on their own.

What are some common reasons why someone would need to go on a ventilator? Low oxygen levels or “hypoxia” can be caused by pneumonia due to bacteria or a virus, “fluid on the lungs” known as pulmonary edema, and blood clots in the lung’s blood vessels or “pulmonary embolism” to name a few examples. High carbon dioxide levels or “hypercapnia” can be causes by a COPD or asthma flare up or a condition where a patient’s brain is not signaling the lungs to take enough breaths such as a brain injury or drug overdose. 

How does the medical team know a patient is ready to come off the ventilator? We make sure the reason the patient was put on the ventilator is getting better or resolved. The team then wakes the patient up from sedation and makes sure the patient can follow simple commands such as giving a thumbs up. We perform a “spontaneous breathing trial” on the ventilator to simulate the patient breathing on their own. If all of these parameters are met, the breathing tube is removed. Patients are monitored closely in the hours after they are taken off the ventilator to make sure they do not need to go back on it. 

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Sherita D. Gaskins-Tillett, MD

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