What Is Mechanical Ventilation?
When a patient has difficulty breathing, a mechanical ventilator assists them by managing the pressure in their lungs.
Contact a product expertWhen a patient has difficulty breathing, a mechanical ventilator assists them by manipulating the pressure in their lungs. Mechanical ventilation typically involves a machine, called a ventilator, to help the patient breathe, as opposed to manual ventilation, which uses a bag valve mask (BVM) that must be operated manually. Mechanical ventilators are designed to provide consistent, automatic breaths with minimal intervention from physicians, nurses, or respiratory therapists. These machines are becoming more common in home, hospital, and pre-hospital settings. Let's take a closer look at why mechanical ventilation is used and how it works.
In a clinical setting, mechanical ventilation keeps a patient stable while the care team treats their underlying conditions. It is often used to protect airways from pulmonary aspiration or to correct imbalanced blood gases. Mechanical ventilation is not used as a therapeutic measure. Health conditions commonly treated by mechanical ventilation include:
There are two primary types of mechanical ventilation: negative pressure ventilation (NPV) and positive pressure ventilation (PPV).
Negative pressure ventilation exposes the thorax to sub-atmospheric pressure, which causes breathing by sucking air into the lungs. NPV is largely out of practice, but it still has a few niche uses (such as preparing a donor lung for transplantation).
Positive pressure ventilation delivers either room air or oxygen gas to a patient's lungs via a tube and is the most common form of ventilation used today. There are two types of positive pressure ventilators: invasive and non-invasive.
An invasive ventilator is used in clinical settings and ventilates the patient via an endotracheal or tracheostomy tube that is inserted into their airway.
A non-invasive ventilator can be used in clinical settings or in the home to help patients who experience conditions like COPD or sleep apnea. It uses a face mask, nasal mask, or helmet to ventilate the patient. Hospitals should have both types of ventilator available.
The terms “mechanical ventilation” and “manual ventilation” are sometimes used interchangeably. However, mechanical ventilation properly refers to the use of a specialized machine, called a ventilator, while manual ventilation implies the use of a bag valve mask (BVM).
Typically, manual ventilation is performed by a trained specialist squeezing a BVM to alter the air pressure in the patient's lung. A BVM is inexpensive compared to a ventilator and does not require electricity to function, making it suitable for rescuers in many different environments and situations. Unfortunately, manual ventilation is subject to human error since the BVM is hand operated.
To avoid human error, many hospitals and EMS providers choose to use ventilators whenever possible. While a specialist will still need to assess a patient's breathing and provide recommendations regarding the ventilator's settings, the machine provides a much more consistent, hands-off means of ventilation. A patient on a ventilator still requires ongoing monitoring and assessment, but overall, these machines help give the care team more time to focus on treating the patient's underlying condition.
A portable ventilator is ideal for keeping patients stable during transport, though not all ventilators are suitable for this purpose. Patients who are attached to a portable ventilator should still have their condition closely monitored by the care team.
Portable ventilators are often reliable, lightweight, and come equipped with enough battery life to sustain most patients for the duration of their transport. This makes them easy to maneuver throughout an ICU or similar clinical setting, while also making them appropriate for use within ambulances or air transport.
Mechanical ventilation is a life-support system that supports or replaces a patient's breathing when they can't breathe adequately on their own. It ensures adequate gas exchange and prevents lung collapse, which enables underlying issues to resolve.
Mechanical ventilation is indicated for respiratory failure due to conditions like ARDS, severe COPD/asthma, pneumonia, shock, neuromuscular weakness, drug overdose, or head injury. Mechanical ventilation reduces the effort of breathing and helps a patient's body stabilize so the underlying issue can be treated.
A mechanical ventilator and a ventilator refer to the same type of device in clinical practice — a machine that moves air in and out of the lungs when a patient cannot breathe adequately on their own. The term mechanical ventilator is simply the more precise, formal name.
Intubation is a procedure that inserts a breathing tube (endotracheal tube) into the airway. Mechanical ventilation is the process of using a machine (ventilator) to breathe for the patient. While ventilation and intubation can be performed individually, they are commonly used together for severe respiratory failure.
Patient safety is secured by adhering to strict protocols during mechanical ventilation. These include continuous monitoring, skilled interdisciplinary teamwork, lung-protective settings, infection prevention, regular sedation assessment, and addressing alarms promptly to prevent complications like ventilator-associated pneumonia (VAP).
Caring for pediatric and neonatal patients requires ventilation technology designed for their distinct physiology. Their smaller lungs and delicate airways call for more refined control, including tailored modes, low tidal volumes with adequate flow, gentle pressure support, sensitive triggering, and continuous monitoring. Together, these features help protect vulnerable patients and support clinicians in reducing the risk of injury.