In this time of COVID-19, we all hear a lot on the news about people being put on ventilators to try to save their lives. While ventilators can offer hope for many patients, not everyone chooses to go on a ventilator when given the choice. There are benefits and potential complications of going on a ventilator. Read on to learn more:

What does a ventilator do?

First of all, it’s important to understand that a ventilator is used to help people breathe when they can’t breathe on their own. It is a type of life support. A tube from the ventilator machine is inserted through the mouth, down into the windpipe. The end of the tube blows oxygen into the lungs, and it allows carbon dioxide and other waste to be exhaled. The ventilator provides air pressure to keep the lungs open, and the tube makes it easier to remove mucus that builds up in the lungs.

What is it like to be on a ventilator?

The tube from the ventilator can feel uncomfortable, but it is not usually painful. Most people need sedating medicine to tolerate the discomfort. Some people require restraints to prevent them from dislodging the tube. For critically ill people, medications might be given to prevent movement—this makes it easier for the ventilator to provide enough oxygen.

Being on a ventilator usually means being in an intensive care unit. While on a ventilator, you cannot eat or drink. Artificial nutrition can be given through a small tube in your nose (tube-feeding). While on a ventilator, you cannot talk. If you’re not sedated, you can write notes to communicate.

How long do people stay on a ventilator?

Four things determine how long a patient may be on a ventilator:

1. The patient’s health and age before they got sick. For people over 65 who require emergency ventilator use, about 2 out of 3 survive to leave the hospital. Older people with chronic conditions tend to have more disabilities after ventilator use and lower survival rates.
2. The reason for needing the ventilator. How serious is being put on a ventilator? In some cases, such as surgery, ventilators are used for a few hours to a few days. Sometimes the ventilator is used for days to weeks—for example, for serious pneumonia or lung injury.
3. How long the ventilator is needed. The longer the ventilator is needed, the higher the chance of long-term complications such as weakness, loss of independence, depression/anxiety, and long-term dependence on the ventilator. For those over the age of 70 or those with health problems, the chance of long-term complications is higher.
4. Your personal values and beliefs. It is important to think about what matters most to you. What gives meaning to your life? Is there any condition that would not be acceptable to you? What would you be willing to try? It’s best to talk to your family and providers about your priorities and medical wishes in advance of a situation where you will need to make these kinds of decisions.

What happens if you decide that you wouldn’t want to be on a ventilator?

If you think that would choose not to have a ventilator, understand that your healthcare team would continue to care for you using noninvasive methods of delivering oxygen. They would use treatments for any distressing symptoms, and ensure you are as comfortable as possible.

No matter what you decide about your care, your providers will respect your decisions.

To learn more about making your healthcare wishes clear and documented, read our blog post, “Understanding Advanced Care Planning.”