A mechanical ventilator is a machine that assists breathing. This article discusses the use of mechanical ventilators in infants.

WHY IS A MECHANICAL VENTILATOR USED?

A ventilator is used to provide breathing support for ill or immature babies. Sick or premature babies often have breathing problems, and cannot breathe adequately on their own. They need assistance from a ventilator to provide “good” air (oxygen) to the lungs and to remove “bad” air (carbon dioxide).

HOW IS A MECHANICAL VENTILATOR PLACED?

A ventilator is a bedside machine that is attached to the breathing tube that is placed into the windpipe of sick babies. Caregivers can adjust the ventilator as needed, depending on the baby's physical findings, blood gas measurements, and x-rays.

WHAT ARE THE RISKS OF A MECHANICAL VENTILATOR?

Most babies who need ventilator assistance have some degree of lung problems, including fragile lungs, which are at risk for injury. Sometimes the delivery of oxygen under pressure can result in damage to the fragile air sacs. This can lead to air leaks, which can make it difficult for the ventilator to help the baby breathe.

• The most common type of air leak occurs when air gets into the space between the lung and inner chest wall. This is called a pneumothorax. This air can be removed with a tube placed into the space until the pneumothorax heals.
• A less common kind of air leak occurs when many tiny pockets of air are found in the lung tissue around the air sacs. This is called a pulmonary interstitial emphysema. This air cannot be removed but usually slowly goes away on its own.

Long-term damage may also occur, resulting in a form of chronic lung disease that is called bronchopulmonary dysplasia. This is why the caregivers closely monitor and attempt to “wean” or decrease the settings on the ventilator whenever possible. It is the baby's needs, however, that determine the level of support needed in most circumstances.