If you have a loved one admitted in the hospital for intensive care attention due to critical illness, chances are high that you will not be at rest. You will feel challenged, fearful, out of your comfort zone, stressed, vulnerable, stressed and overwhelmed. In addition to this, you may even feel handicapped because other people are running the show in this rather complex situation.
How long does it take to wean off a ventilator?
One question that hangs on the minds of those whose loved ones are in the intensive care unit of a hospital is that of “How long does it take to wean off a ventilator?” it depends, it can take between a few days to some weeks and even months. This is however largely dependent on the criticality of the patient’s condition. If however, it appears like it is taking too long, you may want to consider some viable alternatives.
The Different Stages And Time Frame For Ventilator Use
As far as the use of a ventilator is concerned, there are different timelines for different categories of patients. The nature of the admission of the patient also plays a vital role in this regard. Here are some of the stages and time frames you should know about.
1. Soft and Straightforward admissions
If your loved one is a direct admission to intensive care after planned or elective surgery, they should be able to come out of the respirator/ventilator and out of the induced coma in about three days at the most.
Breathing tubes and ventilation after surgery is carried out are measures meant to stabilize and ensure that the patient isn’t bleeding before they are taken off the respirator/ventilator. This is usually very important especially after surgery is carried out.
This is also applicable to some other soft admissions that are made into the intensive care section after a loved one may have developed some breathing associated issues and may need a respirator/ventilator for some time. This is to improve the lungs of the patient by using some extra oxygen and pressure. In such a situation, the induced coma and the ventilator should soon be gone.
2. Ventilation for three to seven days
If the critically ill patient is in a rather complicated admission to the intensive care and appears rather not stable, the ventilator may be needed for more than 72 hours. It is however worthy of note that because been weaned off a ventilator after 72 hours is a bit more difficult because the longer ventilation is needed the greater the risks of complications arising.
Therefore, if a patient that is critically ill is stable and has indicated strength to breathe on their own, then there is no reason why they can’t be taken off the ventilator after about a week. It, however, depends on whether their chest X-Ray is clear and if they can breather by themselves with little support from the respirator/ventilator.
3. Ventilation for more than a week
If your critically ill loved one has found themselves in the intensive care unit for over a week and has been under ventilation for over seven days, you may be worried. In a case where the intensive care team does not feel confident enough to remove the breathing tube after about a week, they may recommend a Tracheotomy.
However, before they can suggest a Tracheotomy, they should attempt to remove the patient from the induced coma first and if the patient is waking up and cooperating, the team should remove the tube. After removing the tube, they should try and find out if the patient can breathe comfortably without the use of the tube.
If this however fails, the team may then recommend a Tracheotomy, this, however, should not be an option until the 10 days of ventilation with breathing tube has elapsed. It should also only be considered when the intensive care team is sure that there is no other viable alternative.
In addition to this, as far as Tracheotomy is concerned in America, the inherent risk lies in the fact that the moment a tracheotomy is carried out, the ICU would want to send the patient to LTAC. This usually doesn’t mean good as the Long Term acute care (LTAC) is made in such a way as to cut cost and not to give the best care.
It, therefore, suffices to say that when LTAC is muted as an option before or after the tracheotomy, you should be alarmed and as such avoid LTAC. The simple reality is that the only place where a patient can be placed on a breathing tube or ventilator with a tracheostomy in intensive care. If this is not clear to you, it may cost you the life of your loved one.
The only reasonable option for patients on ventilation alongside tracheotomy is Intensive care at home. In this situation, highly professional and skilled intensive care unit nurses will provide the needed care in your home for the patient as a viable alternative to the intensive care unit of the hospital.
What Are The Important Things To Be Mindful Of When Having A Tracheotomy?
Tracheostomy is considered when the critically ill patient has gone through a series of failed extubations and is unable to breathe without the aid of a ventilator. In addition to this is the fact that the critically ill patient may be necessitated to remain in intensive care for longer periods using ventilator support as a result of the criticality of their condition.
The advantage of this is that the critically ill patient should be removed from the induced coma and would be able to wake up and communicate. This may, however, be non-verbally as it does not give the patient the ability to talk.
Have it at the back of your mind that with ventilation using breathing tubes in the mouth, it would be necessary for an induced coma. However, a Tracheostomy may be easily tolerable without the need to induce a coma. Furthermore, a Tracheostomy also has the added advantage of removing your loved ones from the ventilator quicker by attempting to breathe without the ventilator just through the oxygen mask using humidified oxygen through the Tracheostomy.
The aim is to improve the frequency which the patient can stay without the respirator/ventilator. This may initially be two hours on the ventilator and two hours away from it. The moment the patient can stay without the ventilator for over 24 hours, they would be able to leave the intensive care unit even while the Tracheostomy is in place. However, most patients should be able to get the Tracheostomy removed while they are in the intensive care unit before they go to the ward.
What Exactly Is A Ventilator And How Does It Work?
A ventilator is simply a machine that assists people with breathing when they are unable to do that on their own. It supports the breathing of the patient while the main reason for activating the ventilation is attended to. The doctors will attempt to get the patient off the ventilator at the earliest possible time.
The ventilator works either by doing the breathing or assisting the patient with the breathing. For this to be achieved, the doctor would sedate the patient using drugs upon which he introduces the tube known as the endotracheal tube (ET) via the mouth into the trachea. Mucus secretions can be cleared through suctioning out via the ET tube. This tube is linked to the ventilator.
If the Ventilator is to be prolonged, a decision may be made to carry out tracheostomy. This is a situation where the doctor creates an opening in the neck of the patient and places in a tube which is then linked to the ventilator.
How Does A Patient Feel When They Are On The Ventilator?
The feeling the tube creates when in the mouth can be quite uncomfortable. This is because the test tube goes through the vocal cords which means they will not be able to speak. A lot of patients find this rather frustrating. They won’t be able to drink or eat, however, teeth cleaning and mouth care can be carried out by staff.
The patients can, however, be fed using tubes that go through their stomach through the nose. To increase comfort, a continuous sedation drip will be passed through using a pump. When improvement is observed in the patient, the tube will be removed while an oxygen mask is used instead. This usually takes between a few hours to some weeks.
How Is The Progress Of The Patient Monitored?
Patients admitted to the intensive care unit are regularly observed to measure their heart rate, blood pressure, oxygen levels, and temperature. Other tests carried out include measuring the carbon dioxide and oxygen levels via a blood test. This is regularly reviewed by the ICU staff. When the patient wakes up, they are reassured and made to understand where they are and why.
What Are The Risks That Come With Ventilation?
One of the major challenges of ventilation is an infection. Even though there are several ways to lower the risk of infection like mouth care and removing the mucus by suctioning, the ET tubes can permit germs to find their way into the lungs which may then lead to an infection of the chest. This may delay the progress of the patient thus extending their time on the ventilator.
What Does Weaning From A Ventilator Mean?
This simply means lowering the ventilator support which may be carried out rather quickly. This is usually more difficult for the patient when they have been on the ventilator for a while.
You may like these articles as well:
How long does it take to wean off a ventilator? This is a question we hope we have been able to answer in this article. It is, however, important to buttress the fact that the time frame is largely dependent on the state of the patient and the medical condition he or she is in for. It could take between days and weeks as the case may be.