Intubation
In order to be placed on a ventilator, the patient must be intubated. This means having an endotracheal tube placed in the mouth or nose and threaded down into the airway. This tube has a small inflatable gasket which is inflated to hold the tube in place. The ventilator is attached to the tube and the ventilator provides "breaths" to the patient.
Sedation While on a Ventilator
If a patient is on the ventilator after surgery, medication is often given to sedate the patient. This is done because it can be upsetting and irritating to the patient to have an endotracheal tube in place and feel the ventilator pushing air into the lungs. The goal is to keep the patient calm and comfortable without sedating them so much that they cannot breathe on their own and be removed from the ventilator.
Ventilator Weaning
Weaning is the term used for the process of removing someone from the ventilator. Most surgery patients are removed from the ventilator quickly and easily. They may be provided a small amount of nasal oxygen to make the process easier, but they are typically able to breath without difficulty.
Patients who are not able to be removed from the ventilator immediately after surgery may require weaning, which is a process where the ventilator settings are adjusted to allow the patient to attempt to breathe on their own, or for the ventilator to do less work and the patient to do more. This may be done for days or even weeks, gradually allowing the patient to improve their breathing.
CPAP, or continuous positive airway pressure, is a ventilator setting that allows patients to do the work of breathing with the ventilator available to help if the patient isn't doing well. A CPAP trial, meaning the patient is placed on the CPAP setting for a set period of time, may be used to determine if the patient can tolerate being removed from the ventilator.
Some patients who are on the ventilator for an extended period of time may be on CPAP during the day, will full ventilator support at night so they can fully rest and continue to heal without being exhausted by the work of breathing.