What Actually Happens When You Go on a Ventilator for COVID-19?

Most of us had never given much thought to what a ventilator does before the COVID-19 pandemic. Or maybe you’d only encountered that uncomfortable feeling of having a tube down your throat during surgery. But now these machines have proven to be a crucial piece of equipment in managing the most severe symptoms associated with coronavirus infections, which are known to cause intense coughing fits and shortness of breath.

In the most severe cases, a coronavirus infection can cause pneumonia, a lung infection that leads to inflammation, lung damage, and possibly death. But in those cases, doctors can use mechanical ventilators to help patients breathe and give their body more time to fight the infection. Whether you know someone who’s on a ventilator or you’re just curious to know more about how these machines work, here’s what you need to know about using ventilators for COVID-19 patients.

What does a ventilator actually do?

The first thing to know is that mechanical ventilators aren’t some newfangled fancy machine. “A ventilator is really a very simple device that’s been in use for decades,” Enid Rose Neptune, M.D., pulmonologist and associate professor of medicine at Johns Hopkins University School of Medicine, tells SELF. “There’s nothing cutting edge, cosmic, or otherworldly about it.”

Ventilators help patients breathe via two very important processes: ventilation (duh) and oxygenation. Ventilation is the process by which the lungs expand and take in air, then exhale it. A mechanical ventilator helps with this by pushing air into the lungs from an external device through a tube that is inserted into the patient’s airway. While patients are intubated, they can’t talk and are given sedative medication to make them more comfortable (medications that, according to recent reports, are now in short supply).

Oxygenation is the process by which our lungs breathe in oxygen, which then makes its way to the bloodstream and internal organs. Oxygen is necessary for those organs to function, and a ventilator can provide more oxygen than you might get from just breathing in regular air. In fact, patients dealing with COVD-19 tend to require relatively high levels of oxygen compared to people who need to be ventilated for other reasons, Dr. Neptune says, and this is one of the many unique challenges of treating those patients.

All kinds of complex oxygenation and ventilation pressure settings need to be individualized and consistently monitored for each patient who’s on a ventilator. And those settings often change as time goes on, Dr. Neptune says, which makes the idea of “splitting” a ventilator between multiple patients very challenging to actually accomplish.

There are other, noninvasive types of ventilation that don’t require intubation (having a tube down your windpipe) and deliver oxygen through a mask instead. These are usually saved for less severe cases.

When someone has a condition that affects the lungs, which might be something like an injury to the muscles the lungs need to draw a breath or a respiratory illness like COVID-19-related pneumonia, mechanical ventilation can help give their body the oxygen and time it needs to recover.

How long do people usually stay on ventilators?

Depending on the condition that needs to be treated, a patient might be on a ventilator for a few hours or days. But there are reports that people with COVID-19 who are put on ventilators stay on them for days or weeks—much longer than those who require ventilation for other reasons—which further reduces the supply of ventilators we have available.

In one study of 18 patients in the Seattle area, the average intubation time was 10 days, for instance. And previous research indicates that prolonged intubation times like these are very much the minority of cases outside of the coronavirus world. But Dr. Neptune says it’s hard to know exactly how long coronavirus patients need that kind of care because our understanding of the infection is still evolving.

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