"ventilation is brutal" - what does this mean?

[ellanwood]

I saw this on another thread and didn't want to derail it by asking. Also a news report said something similar. I just don't understand what this means or how it is brutal. I thought it was just oxygen.

I think because you have to be sedated, tube put down etc.

It's brutal because it's invasive and involves a tube being passed down your trachea ( intubation). You also need to be sedated as otherwise your body could not tolerate something so invasive. There is also a risk of infection.

It's not just oxygen, the ventilator takes over the breathing for you pushes air into the lungs and exhales for you too.
As much as this is controlled to minimise damage it's not as good as the body can do itself so there is usually an element of lungs damage.
The tube in the trachea needs to be snug to allow the ventilator to push into the lungs so this causes damage too
All this along with the drugs are not what your body will do naturally so long term damage is a very high risk
Sorry if this is scary

My DF was on a ventilator before he died from lung cancer, and after intubation as he continued struggling to breathe, a high pressure ventilator mask was used, strapped to his face. My (nurse) sister was very distressed by this as she said it was like an elephant sitting on your face and chest forcing oxygen in. There was no hope and his care was palliative, and my mother agreed the suffering was too much with no hope of improvement so she gave consent to remove it. That is my only knowledge of its intensity.

Intubation is painful.

It's vile and painful and brutal is an excellent way to describe it.

Erm … dont want to upset you further but getting ventilator treatment in ICU is not a comfortable thing to happen to anyone, they have to give you the oxygen via a tube into your lungs that is being regulated and pumped into you by the ventilator, you have to be sedated for the treatment to be given to you, so this is what they mean when they say its brutal, if its in line with what you've seen or heard about ventilators. I only know this as my daughter has been ventilated in past when we nearly lost her and my unborn grandchild. They pulled through and the ICU staff were fantastic with her and baby, but It was not a nice thing to go through. 🙁

Thank you so much for your honest answers. It does sound horrific.

@Willows76 - so glad your daughter and grandchild survived. Worth the ordeal.

@GreatDryingOut - sorry for your loss of your DF.

My DH had a heart operation in 2018 and had to be on a ventilator for a period of time in recovery. He suffered terrible from after affects such as pain and soreness in the neck and throat and chest, plus they broke one of his front teeth in the process x

So do you actually experience all this pain or are you sedated first ? Sorry stupid layman question

Please get proper medical advice if any of this talk is upsetting to you from nhs site. My daughter said she knew what was going on around her but she couldnt feel a thing as she was partially sedated (because chance of baby being sedated wasnt a good thing) before they did anything to her. She had sore throat when she came out of ICU, apart from that she was okay and a bit shook up. 🙁

My fiance was on a ventilator after open heart surgery a few weeks ago, nothing can quite prepare you for seeing a machine breathing for and keeping your loved one alive - I will never forget it and I work in a hospital so am a bit more familiar with all the medical equipment etc then some.

He was unconscious for the majority of it (thankfully) but I know he was briefly woken up to see if he could breath unaided whilst the intubation tubes were still in and he definitely remembers that.

I would say it's mentally and physically a brutal thing to go through (tho also life saving in a lot of cases.)

Brutal is the absolute right way to describe it. I saw both my parents ventilated before they died. My Dad was ventilated for about a week while they tried to figure out what was going on with him. He had problems with his blood pressure when sedated too deeply so they had to keep reducing it, when they reduced it he was obviously in pain and was trying to bring his hands up and they had to strap his arms down as he was trying to pull the tubes out. Sedation also had to be reduced while they tried to wean him off. I don't know whether this is always the case. He was a very fit man age 70. It was utterly the most horrendous thing I have ever seen in my life, I will never forget the panicked look in his eyes, he couldn't communicate and I wouldn't wish it on anyone. I believe the recovery if you survive can be quite difficult and some ventilated patients are left with mental health issues. It really isn't just a case of having enough ventilators and it all being ok as it's been made out in some cases. I can see why many older/frail people would not be candidates for ventilation at all.

Omg that’s horrific . Poor people

What a terrifying prospect. Either death without ventilation or probable death - but at least a chance - with ventilation, but a very painful and frightening ordeal.

None of us know whether this is something we will have to deal with this year or next, either ourselves or those we love so much.

I'm sorry, I should have thought more about what I wrote. Please bear in mind that I wrote it from my point of view - standing watching a ventilated patient. The staff did everything they could to make my Dad comfortable and I do think his moments of distress were few. He was sedated heavily almost all of time and I hope that the moments he wasn't he was still so sedated that he wasn't quite as lucid as I may have thought. Many people do survive ventilation and come out the other side. I have found all the talk of it lately a bit triggering. It's really important for us all to remember that if this is the path we or our loved ones tread in the future we will be looked after by amazingly caring staff who will do all the can for us.

If you have a general anaesthetic for a surgical procedure, you are intubated and on a ventilator for the duration of the surgery and then the breathing tube is removed in the recovery area and a normal oxygen mask. Most people don't remember any of this.
If you are sick enough to require admission to an intensive care unit, you are sedated and then the breathing tube is passed. It can't be performed on an awake patient. The ventilator is then connected and the appropriate settings for that patient are managed carefully throughout. It is not necessarily because that person can't breathe unaided, more to ensure all organs are supported during treatment.
In the case of Covid19 or respiratory failure of any type, patients are tiring and the work of breathing is getting too difficult or they are not receiving enough oxygen during normal breathing.
Sometimes a CPAP non invasive mask can be enough as this is similar to putting your head out of a moving car window and opens up the lung bases and reduces tiredness and the hard work of taking a breath.
If full mechanical ventilation is required, an anaesthetist will sedate the patient as above.
Once on the ventilator, enough sedation is given via continuous infusion to ensure there is no awareness. It is only when the patient is deemed ready to try to come off the ventilator that sedation is reduced. The ICU team are there at all times ensuring the patient doesn't panic and is ready for the tube to be removed.
For people who are mechanically ventilated for a longer period of time, they are slowly 'weaned' onto different ventilator settings to see if they can take breaths independently. These are the times which people may remember. This means that the patient has improved enough to have a trial run of getting off the ventilator. The chest muscles can become weakened so require time to build back up so it is sometimes done slowly.
So ventilation isn't brutal as such and a very necessary and carefully managed intervention.

www.dailymail.co.uk/news/article-8230775/Is-proof-live-saving-ventilators-actually-deathtraps.html
Having read this article today, I have changed my mind and would not want to be put on a ventilator for Covid-19.

@mykingdom

Many anaesthetists use less invasive airway management techniques for certain surgeries, so its not a given that one would be intubated for surgery.

It is absolutely brutal on the body. The drugs and indeed the entire ITU experience leaves many people with long term effects. I appreciate it’s often needed but it is associated with risks.

My Dad's best friend refused ventilation having seen his mother be ventilated and unable to say goodbye and have a compassionate death. My friend was ventilated after a horrific quad bike accident and he was seriously unwell from side effects afterwards. He still has a problem with his throat 2 years later.

I’ve been ventilated in ICU and although it was a very uncomfortable experience it wasn’t painful. The dry mouth and not being able to drink was horrible.

The worse part of the ICU experience were the hallucinations which I believe were due to the morphine painkillers.

I’d certainly accept ventilation if I became ill with Coronavirus. I’m shielded though so they might not bother to offer me one!

I've been ventilated and I can tell you it is brutal. Having a central line put in your neck and having umpteen venflons In, catheter in. Waking up with a tube down your throat is fucking terrifying. Then comes the physio for your cheats and lungs. Then came the ptsd.

Fucking brutal.