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This Is What Happens to Your Body on a Ventilator

The life-saving apparatus, explained.
Nurse patient hospital ventilator

In severe cases of respiratory illnesses like COVID-19, patients may be placed on a ventilator, a process which is their best hope of survival. "A ventilator takes over the work of breathing when you are struggling to breathe in enough oxygen or breathe out enough carbon dioxide," explains Leann Poston, MD, a physician with Invigor Medical in New York. "It allows a higher concentration of oxygen to be delivered to the lungs. You might require a ventilator if you are working so hard to breathe that you do not have enough available energy to fight infection or recover from an illness." Although this mechanical breathing assistance can be life-saving, it can also be physically traumatic. Here's what happens to your body on a ventilator.

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You May Experience Muscle Weakness

"The longer a patient is on a ventilator, the more muscle breakdown and atrophy there will be," says Taylor Graber, MD, a resident anesthesiologist in San Diego. "Once a patient is extubated and they are liberated from the ventilator, it is very common for there to be significant weakness or exhaustion, which requires physical therapy and rehabilitation for days, weeks, or potentially months to recover from."

You'll Need To Take Care Of Your Epidermis

"Dry skin from being in the ICU environment can occur. Hair can fall out due to the stress of the illness, and bruising can occur from having multiple IVs during your hospitalization," says Seema Sarin, MD, assistant medical director of EHE Health. "These take time to heal, but having proper nutrition, managing stress, exercising, hydrating your skin with moisturizer, and drinking plenty of fluids can help."

You Experience Soreness

"Patients are often sore in their ribs and abdomen," says William Lynes, MD, a urologist in Temecula, California. "They may have had to have chest tubes placed because of collapsed lungs, and these are very uncomfortable."

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It's A Foreign Experience

"It makes the patient breathe on its schedule, and so the natural tendency for the patient is to fight the ventilator," says Lynes. "That is why high doses of narcotics or sedatives are required and often paralyzing agents to allow the ventilator to breathe for the patient."

You Can Experience ICU Psychosis

"When in the ICU, and especially on a ventilator, there is profound mental anguish associated with that which lasts a very long time," says Lynes. "I had horrible, demonic-type dreams and visions on the ventilator that are still, now 22 years later, fresh in my mind. ICU psychosis is caused by many factors in the ICU. The drugs used, the deprivation of time/circadian rhythm, and the illness all contribute."

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You Can Have Vocal Cord Damage

"The tube can damage your vocal cords," says Amy Baxter, MD, a pedatric emergency physician and pain researcher. "I had one note I couldn't sing for a year. Other people may have permanent vocal changes." Following your doctor's instructions, resting your voice, and drinking plenty of water can help in recovery, says Sarin. 

You're Exhausted 

"The body and the mind are exhausted. Mentally, you have been on sedatives, or paralytic agents to relax your mind and body," says Jacob DeLaRosa, MD, chief of cardiac and endovascular surgery at Portneuf Medical Center in Pocatello, Idaho. "Your body has been pushed and pulled every which way by medical staff as you have not been able to do these movements on your own."

What Happens Afterward?

"Coming off the ventilator is a process known as a 'weaning trial' where the patient undergoes a spontaneous breathing trial for 30 to 120 minutes," says Dr. Daren Newfield of AICA Orthopedics. "This process can take several days, in some situations weeks, before the patient is back to normal and feeling well."

"Focusing on the positive facts, like that you survived through a serious illness, is important to keep in mind during the time of recovery," says Mary Dale Peterson, MD, president of the American Society of Anesthesiologists. 

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Emilia Paluszek
Emilia specializes in human biology and psychology at the University at Albany. Read more