Ventilatory Support − Mechanical Ventilation

Mechanical ventilation or ventilatory support means to be on a machine that helps you breathe.

The patient has a tube inserted through the nose or mouth into the trachea (windpipe) that is attached to the ventilator. The ventilator is a machine that can deliver a breath to a patient who may be having difficulty breathing or who may not be breathing at all.

The number of breaths and the amount of volume or pressure given at each breath are set on the machine by the Cardiac Intensive Care Unit (CICU) team.

Often patients may need to be on a breathing machine either before, during, or after a heart operation or a procedure, such as a cardiac catheterization.

Patients need to be mechanically ventilated at these times because they are given anesthesia or sedation that may suppress their own drive to breathe. Often it is necessary to control breathing so the heart itself can rest. Occasionally, patients will be able to come off the ventilator prior to leaving the operating room.

After surgery, most babies will arrive in the Cardiac Intensive Care Unit on the ventilator. The length of time a patient remains on the ventilator depends on the severity of the cardiac defect and the type of surgical procedure performed.

Does it hurt?

Patients receive sedation while they are on the ventilator. It is usually important for them to stay comfortable and somewhat still in bed.

Sometimes patients will need arm or leg restraints. This is to prevent them from pulling out any tubes or intravenous catheters. This also prevents any damage to their airway while the breathing tube is in place.  They may not tolerate breathing yet if the breathing tube was accidentally pulled out.


If the patient is doing well after the surgery, the decision is made to extubate (pull the breathing tube out) the patient.

When it is time to take the patient off the breathing machine, settings on the ventilator are turned down. This allows the patients to breathe more on his or her own.

When patients are awake enough, the breathing tube is removed, and the ventilator is turned off.

After the patients are off of the ventilator, they may need to temporarily wear oxygen, delivered 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 indicated.  

Who operates the controls on the ventilators or performs other respiratory treatments?

Respiratory therapists are professionally trained staff who work with all aspects of respiratory care. Cincinnati Children's Cardiac Intensive Care Unit includes 13 respiratory therapists who staff the unit 24 hours a day, seven days a week.

Respiratory therapists work with many different types of patients, all of whom have different needs.

If you need to contact someone in respiratory care for the Cardiac Intensive Care Unit, call Jenni Raake, 513-636-4060.

Last Updated 07/2015