Intubation and Mechanical Ventilation

Why is this procedure done?

Sometimes, you need help breathing. This may be for a short time, like during surgery. It may be for a long time if you are getting better after being sick or hurt. To help you, the doctors will put in a breathing tube. This is also called an endotracheal tube or ET tube. The procedure is called an intubation. The breathing tube goes down your windpipe into your lungs. The breathing tube can also be put in your windpipe by your doctor making a small hole in your throat. ‚
Your breathing tube is connected to the ventilator. It is a special machine that can help you breathe. It may do some of the breathing work for you or it may do all of the breathing work. This does not fix the disease, but may keep you alive until the problem is fixed. You may need to have a breathing tube and ventilator to: ‚

Help you breathe easier until you can breathe on your own
Help you get more oxygen into your body and get carbon dioxide out of your body
Give you needed air supply or emergency care right away
Help with breathing during surgery or after an injury
Open the airway
Protect the lungs
Remove blockages from the airway
Treat other health problems

What will the results be?

The machine will be able to breathe for you when you are not able to.
You will have enough oxygen supply to your lungs and to your body.

What happens before the procedure?

Intubation is often done in an emergency. Then, no preparations are done.
If intubation is needed for surgery, your doctor will talk to you about the alternatives as well as the potential risks and problems of this procedure. Your doctor will give you specific instructions and other special directions.
Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
Your doctor will do an exam and may order:
- Lab tests
- X-ray

What happens during the procedure?

You may be given a drug to make you sleepy. Another drug may also be given to numb your throat and help your muscles relax when the tube is put in.
When you are asleep, your doctor will put an oxygen mask on your face to help you breathe for a few minutes. Your doctor will tilt your head gently to make it easier to put in the breathing tube.
Your doctor will use a special tool to move your tongue from the back of your throat. This will make it easy to see your vocal cords. The doctor will put one end of the breathing tube into your throat. The tube is gently pushed down until it reaches your windpipe.
Your doctor will remove the tool and secure the tube in place. There is often a small balloon at the end of the tube that is blown up to help it stay in place. The tube will be taped to the corner of your mouth. Your doctor will connect the other end of the tube to the ventilator. This a machine that will help you breathe.
In some cases, the tube is put through your nose instead of the mouth. The tube may also be put through a cut made in your neck. This is a tracheostomy. It is done if there is something blocking your throat or if you need to have the tube for more than a few weeks.
The procedure may take less than 5 minutes.

What happens after the procedure?

You will have a chest x-ray. This is to make sure that the tip of the tube is in the right place. Your doctor will listen to your lungs and may take blood test to see how well the ventilator is working.
You will have a little discomfort because of the tube. It may bother your throat and make you cough. The staff will watch you closely.
You may be restrained while the breathing tube is in your trachea. This is done so that when you wake up from the procedure you dont accidentally remove the tube when the balloon is inflated.
You will not be able to eat, drink, or talk until the tube is removed.
The staff will take out your breathing tube when you are awake or strong enough to breathe.
Doing coughing and deep breathing exercises will help keep your lungs clear. The staff will help you do these exercises.
You may have a sore throat and pain afterwards. Your doctor will give you drugs for pain.
The length of your hospital stay will depend on the reason why you have this procedure. It may be a few hours, few days, or much longer based on your condition.

What drugs may be needed?

The doctor may order drugs to: ‚

Prevent infection
Help you relax
Help you sleep

What problems could happen?

Injury to your lungs, windpipe, or vocal cords
Injury to teeth, lips, or tongue
Collapsed lung
Stomach bleeding
Tube is put into your food tube
Low blood pressure
Infection
Trouble getting off the ventilator and your body able to breathe well

Where can I learn more?

American Thoracic Society ‚
http://patients.thoracic.org/information-series/en/resources/mechanical-ventilation.pdf ‚
Journal of the American Medical Society ‚
http://jama.jamanetwork.com/article.aspx?articleid=185472 ‚
National Heart, Lung, and Blood Institute ‚
http://www.nhlbi.nih.gov/health/healthtopics ‚
New Wales South Government ‚
http://intensivecare.hsnet.nsw.gov.au/intubation ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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