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What are Important Considerations for Mechanical Ventilation

George Barnes, MS, CCC-SLP

September 15, 2023

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Question

What are some important considerations regarding mechanical ventilation and its effects on natural breathing processes and patient stability?

Answer

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.


george barnes

George Barnes, MS, CCC-SLP

George Barnes MS, CCC-SLP, BCS-S is a Board Certified Specialist in swallowing and swallowing disorders and has developed an expertise in dysphagia management focusing on diagnostics and clinical decision-making in the medically complex population. George yearns to make education useful and quality care accessible. With a passion for food and a deep appreciation for the joy and connection it brings to our lives, he has dedicated his life to helping others enjoy this simple, but deep-rooted pleasure.


Related Courses

20Q: Beyond the Swallow - Tracheostomy Tube and Ventilator Management
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  'Great info!'   Read Reviews
This course addresses the various questions that may arise for the medical SLP involved in the care of patients with tracheostomy and/or mechanical ventilation. Topics include causes of respiratory failure, consequences of tracheostomy/ventilation, risk management related to intervention, and considerations for assessment and treatment of swallowing and communication, including the use of speaking valves.

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Key factors related to respiratory failure and oral intubation, including levels of respiratory support and effects of intubation on the larynx and swallow, are reviewed in this course. A decision-making framework for creating evidence-based, individualized plans of care is described within the context of a case study.

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  'Excellent speaker: informative and knowledgeable'   Read Reviews
This is Part 1 of a two-part series. Respiratory disease, respiratory failure, oral intubation, effects of intubation on the larynx and the swallow, and dysphagia management are discussed in this course. Risk factors and salient features of dysphagia after extubation are described in order to help clinicians effectively evaluate and treat their patients.

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This is Part 2 of a two-part series. An overview of tracheostomy tube and mechanical ventilator management, including their effects on airflow, speech and swallowing, is provided in this course. Discussion includes speaking valves, common challenges, and ways to improve outcomes in this complex patient population.

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