Back to Top ICU Procedures | The Ottawa Hospital Favourite Icon
 

Mechanical Ventilation

What is mechanical ventilation?
Mechanical ventilation is a form of artificial respiration that uses a breathing machine (ventilator) to assist patients with their breathing.

What are the benefits?
Mechanical ventilation is used when the lungs are not functioning properly. This breathing support may be used to help get enough oxygen to the body and to remove carbon dioxide.  Sometimes ICU patients need support from a ventilator because they are not awake enough or strong enough to breath safely on their own.

What are the risks?
Patients who require a breathing machine are at increased risk to develop infections of the lungs, called pneumonia. Occasionally, patients may develop a collapsed lung from the pressure used to push the air into the lungs. Both of these complications require treatment.

Helpful Links

Intubation

What is an intubation?
The most common use of this term in the ICU refers to placing a breathing tube into a patient’s windpipe (endotracheal intubation).

What are the benefits?
Endotracheal intubation is necessary if the patient requires mechanical ventilation. Patients in a coma may require intubation to protect their lungs from aspiration (secretions going into the lungs). Other patients may require help getting enough oxygen into their bloodstream.

What are the risks?
In critically ill patients, placing the tube can be difficult, and may result in dangerous alterations in breathing or blood pressure. The mouth, teeth, and upper airway can be damaged while the tube is being placed, as can the vocal cords. This occurs very rarely.

Helpful Links

Central Venous Catheterization

What is a central venous catheter?
A central venous catheter is a special IV line that is inserted into a large vein in the body. They can be inserted into the shoulder, neck, or groin.

What are the benefits?
These special IVs are used when the patient needs a reliable IV that can last many days, or needs special medications that cannot be given through the smaller arm veins.

What are the risks?
Bleeding and infection are the main complications associated with central catheters, although they are rare. A collapsed lung is a very rare complication, if this occurs a tube may be required to re-expand the lung.

Helpful Links

Cardiopulmonary Resuscitation (CPR)

What is cardiopulmonary resuscitation (CPR)?
CPR is the combination of life saving measures performed to restart lung and heart function in a patient who has stopped breathing and/or whose heart has stopped beating. This is called a cardiac arrest. Measures may include pushing down on the chest (chest compressions), attempting to restore the heart rhythm to normal (with an electric shock), administration of medications and artificial respiration using a face mask or breathing tube.

What are the benefits?
In the event of cardiac arrest, the patient is likely to die.  If the problem that caused the cardiac arrest can be identified and fixed,  successful CPR is the only chance for survival.  Unfortunately CPR is not often successful.
What are the risks?
Most patients who suffer cardiac arrest will die even if they receive CPR. Some patients may survive but will suffer serious injury to the brain and other organs from lack of blood flow. A minority of patients will survive without injury.

Helpful Links

Arterial lines

What is an arterial line?
An arterial line is a catheter that is inserted into a artery, as opposed to a vein (as is the case for IVs). They may be inserted into the wrist or groin.

What are the benefits?
The arterial line provides a way to constantly measure a patient’s blood pressure and may be essential to treat the patient safely. Arterial lines may be useful in patients with very high or low blood pressures. The arterial line also provides access for frequent blood sampling, as blood can be withdrawn from the patient through the catheter.

What are the risks?
The major complications associated with the arterial line are bleeding and infection.  On very rare occasions the catheter may injury the artery it is inserted into.

Helpful Links

Chest tubes

What is a chest tube?
A chest tube is a hollow tube placed between the ribs into the small space between lung and the chest wall (called the pleural space). The chest tube provides a way to drain air, blood, or infection from the pleural space.

What are the benefits?
A chest tube is used when the patient has air or fluid in the pleural space that needs to be removed. Often this is necessary to drain blood or infection from around the lung, or to re-expand a collapsed lung.

What are the risks?
The potential complications associated with the use of a chest tube include bleeding, infection and poor positioning of the tube itself. After placing a chest tube the doctor will check a chest x-ray to assure that the tube is in the correct position.

Helpful Links

Tracheostomy

What is a tracheostomy tube?
A tracheostomy tube is a small tube placed directly into a patient’s windpipe through the neck. It replaces the breathing tube that is inserted through the mouth. The surgical procedure of inserting a tracheostomy tube is called a tracheotomy.

What are the benefits?
A tracheostomy tube may be needed for ICU patients requiring long-term mechanical ventilation. The decision to perform a tracheostomy on a particular patient depends upon the circumstances surrounding that patient and most often follows use of breathing tube inserted through the mouth.

What are the risks?
The potential complications associated with the insertion of a tracheostomy tube are bleeding and infection, although both are rare.

Helpful Links

Feeding Tubes

What is a feeding tube?
Due to illness or injury, some ICU patients cannot eat in the usual fashion. Therefore, nutrition is often given to patients through feeding tubes or intravenously. Where possible, the preferred way to provide nutrition to ICU patients is through the feeding tube, which can be inserted into the nose, mouth, or directly into the stomach though the skin.

What are the benefits?
Adequate nutrition is essential to the healing process. In patients who cannot eat normally, a feeding tube is the best way to receive nutrition.

What are the risks?
In general, the risks are very low. The feeding tube may become displaced, or the process of feeding may result in electrolyte imbalances. Insertion of the feeding tube can cause bleeding or infection, although this is rare. The doctor, dietician, pharmacist, and nursing staff will closely monitor patients receiving feedings.

Helpful Links