Complications of Ventilator Use

A ventilator is a machine that helps you breathe when you're sick, injured, or sedated for an operation. It pumps oxygen-rich air into your lungs. It also helps you breathe out carbon dioxide, a harmful waste gas your body needs to get rid of.

Even while they help you breathe, ventilators sometimes lead to complications. These problems can result from the ventilator itself, or from things that are more likely to happen when you're on a ventilator.

Why You Might Need a Ventilator

You may need to be on a ventilator for days, weeks, or more if you have an injury or illness that makes it hard to breathe.

A ventilator also may help you breathe during surgery where you are asleep (general anesthesia), but this is usually for no more than a few hours. Doctors sometimes use ventilators for operations because anesthesia drugs can interfere with your breathing.

To put you on a ventilator, your doctor sedates you. Then, they put a tube down your throat and into your windpipe. This makes it easier to get air into and out of your lungs. The process is called intubation.

Ventilator Complications: Infection

The breathing tube in your airway could let in bacteria that infect the tiny air sacs in the walls of your lungs. Plus, the tube makes it harder to cough away debris that could irritate your lungs and cause an infection.

This type of infection is called ventilator-associated pneumonia, or VAP. It’s especially risky because you may already be quite sick when you're put on a ventilator. VAP can make it harder to treat your other illness.

Doctors treat it with antibiotics. In some cases, VAP might require special types that can fight antibiotic-resistant bacteria.

Even if you already have an infection, like a viral infection of your lungs, you can get VAP on top of that. Doctors call this a "superinfection."

Ventilation also increases your risk of infections in other areas, like your sinuses.

Ventilator Complications: Lung Damage

Medical staff members carefully measure the amount, type, speed, and force of the air the ventilator pushes into and pulls out of your lungs. Too much oxygen in the mix for too long can be bad for your lungs. If the force or amount of air is too much, or if your lungs are too weak, it can damage your lung tissue. Your doctor might call this ventilator-associated lung injury (VALI).

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Among the conditions VALI can lead to are:

  • Pneumothorax: A hole or holes in your lungs that release air into the opening between your lungs and the wall of your chest. This can cause pain and loss of oxygen. It might also cause your lungs to collapse, which is an emergency.
  • Pulmonary edema: The buildup of liquid in your lungs. Your lungs may collect more liquid if you already have pneumonia.
  • Hypoxemia: Too little oxygen in your blood. Damage to your lungs can cause this. Medical staff will notice it if your blood oxygen levels start to drop and you are short of breath.

 

Ventilator Complications: Other Risks

Delirium: You’re usually unconscious or heavily sedated when you're on a ventilator. Either way, you take strong medications. Sometimes, these drugs may take some time to wear off even after the tube is removed from your airway.

You may have a hard time reading, writing, or thinking clearly. You also might notice a poor memory, have trouble sleeping, feel anxious, or have unusual emotions like paranoia. Talk to your doctor about these effects, which should fade over time.

Immobility: Because you're sedated, you don’t move much when you're on a ventilator. That can lead to bedsores, which may turn into skin infections. You're more likely to get blood clots for the same reason. Your muscles, including those that normally help you breathe for yourself, may get weak. You might need rehab with a physical or respiratory therapist.

Vocal cord problems: When your doctor removes the breathing tube to take you off the ventilator, it can damage your vocal cords. Expect some soreness and a raspy voice at first. But let your doctor know if it’s hard to breathe or speak after the tube comes out.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on March 26, 2020

Sources

SOURCES:

American Thoracic Society: "Mechanical Ventilation."

Mayo Clinic: "Delirium."

Merck Manual: "Drugs to Aid Intubation," "Tracheal Intubation."

National Heart, Lung, and Blood Institute: "Ventilator/Ventilator Support."

UpToDate: "Diagnosis, management, and prevention of pulmonary barotrauma during invasive mechanical ventilation in adults," "Physiologic and pathophysiologic consequences of mechanical ventilation," "Ventilator-induced lung injury."

Winchester Hospital Health Library: "Intubation and Mechanical Ventilation."

Richard Gray Lassiter, MD, Emory Healthcare.

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