What is Ventilatory Support − Mechanical Ventilation?
Mechanical ventilation or ventilatory support means the patient is on a machine that helps them breathe. A tube is put in through their nose or mouth into the trachea (windpipe). It is attached to a ventilator or "vent".
The ventilator is a machine that can give a breath to a patient who may have trouble breathing or is not able to breathe. The number of breaths and the size of the breath (amount of volume or pressure) are set by the Cardiac Intensive Care Unit (CICU) team.
Reasons for Mechanical Ventilation
Often patients need to be on a vent either before, during or after a heart operation or a procedure, such as a cardiac catheterization.
Patients need mechanical ventilation at these times because they are given anesthesia or sedation that can suppress their own drive to breathe. Often the vent is needed to control breathing so the heart can rest. Sometimes, after shorter procedures, patients will be able to breathe on their own before leaving the operating room and will not require a vent. After surgery, most babies arrive in the CICU on the vent. How long a patient stays on the vent depends on how severe the cardiac defect is and the type of surgery performed.
Description of Mechanical Ventilation
Does it hurt?
Patients receive sedation while they are on the ventilator. This helps with their comfort and helps them stay calm and limits movement in bed.
Sometimes patients will need arm or leg restraints. These restraints prevent the patient from pulling out any tubes or IV lines. Restraints also help prevent damage to a patient’s airway while the breathing tube is in place.
Extubation
If the patient is doing well after surgery, the care team may decide to extubate (pull the breathing tube out).
When it is time to take the patient off the vent, settings on the vent are turned down (weanted). This weaning process allows the patient to breathe more on their own. A CPAP trial is a breathing test the care team might trial to help assess the patients breathing muscles after surgery.
When the patient is awake and strong enough, the breathing tube is removed and the ventilator is turned off.
Once the patient is off the vent, they may need to wear oxygen for a little while. The oxygen is given through a nasal cannula (two-pronged plastic tubing) that fits into the nose.
In some cases, other treatments such as chest physiotherapy (CPT) or breathing treatments are needed.
Who operates the controls on the ventilators or performs other respiratory treatments?
Respiratory therapists are professional, trained staff who work with all aspects of respiratory care. Cincinnati Children's CICU staffs multiple therapists on the unit 24 hours a day, seven days a week.
Respiratory therapists work with many types of patients with varied needs.
If you need to contact someone in respiratory care for the CICU, call Angela Saunders at 513-305-8776.
