What are some important considerations regarding mechanical ventilation and its effects on natural breathing processes and patient stability?
Mechanical ventilation plays a crucial role in saving lives, but it's essential to understand its impact on natural respiratory processes. When a patient is on a ventilator, certain natural functions are disrupted. The air delivered through the ventilator bypasses the nose and mouth, which normally filter and humidify the air, leading to potential issues with dryness and coldness in the lungs. This can result in increased secretions as the lungs try to compensate.
Additionally, mechanical ventilation can interfere with the coordination between breathing and swallowing, increasing the risk of food or liquid entering the lungs while breathing. The subglottic pressure needed for proper swallowing and airway protection can be compromised due to the nature of the ventilation process.
A critical factor in determining the readiness of a patient for extubation and discontinuation of full support is their medical stability. If a patient still requires full ventilatory support and the endotracheal tube has been removed, starting therapeutic interventions prematurely can be detrimental. Ensuring medical stability is key to preventing further decline and guiding appropriate decision-making regarding the timing of interventions.
This Ask the Expert is an excerpt from the course, Breathe, Speak, Eat: What the SLP Needs to Know About Trachs and Vents, presented by George Barnes, MS, CCC-SLP.