If a patient is temporarily unable to breathe on their own, doctors use artificial ventilation.
The reasons for this can be very different.
After a few hours of short-term ventilation, as is usual during an operation, no special weaning is necessary. Natural breathing resumes on its own after the anesthesia has worn off.
If the patient is ventilated for more than a week, the respiratory muscles weaken. Patients with damaged respiratory muscles or lungs cannot breathe on their own. To enable independent breathing, patients must gradually train their ability.
This process is called weaning.
Weaning refers to the step-by-step weaning from the ventilator back to independent breathing @ Jorge Ferreiro /AdobeStock
If a patient has been on a ventilator for a very long time, weaning is a major challenge. Different techniques are used for this:
In assisted spontaneous ventilation, ventilation is gradually reduced and breathing is gradually resumed.
There are often controlled alternations between phases of ventilation and spontaneous breathing. The respiratory muscles have to take over breathing for a short time, but can then rest again during ventilation.
The phases of spontaneous breathing gradually become longer and longer. In this way, the patient trains the respiratory muscles. This continues until breathing is fully functional. Depending on the individual case, further measures are used to facilitate breathing.
These include, for example
It is important that doctors keep precise records of the weaning measures and monitor the patient closely.
After simple operations, doctors check the patient's breathing in the recovery room. In such cases, there are usually no problems.
If the ventilation lasts longer, doctors carry out weaning in the intensive care unit. Some hospitals have special weaning wards for more complicated cases .
Some cities also have their own weaning centers that specialize entirely in ventilation weaning.
During weaning, the patient shouldlearn to breathe independently again step by step @ Ralf Geithe /AdobeStock
Since 2004, there has been a new profession in Germany: respiratory therapist.
Respiratory therapists are employed in a variety of settings:
Respiratory therapists are specialists in the care of patients with breathing difficulties. They work closely with lung specialists. They take over the care of patients in all areas related to breathing.
Respiratory therapists are suitable for complicated cases. If the weaning works without any problems, the staff in the intensive care unit or in the recovery room will carry out the weaning.
Artificial respiration saves the lives of many patients, but is also associated with major risks. For example, inflammation and infections of the respiratory organs can occur more easily.
Excessive ventilation can damage the lungs. This is why doctors start weaning as soon as possible. Monitoring the patient is also very important here in order to be able to react quickly in the event of complications. The monitoring concerns the heart rate and oxygen saturation in the blood.
Psychological problems can also be problematic: The feeling of not being able to breathe triggers great anxiety in many patients. This in turn leads to a deterioration in the ability to breathe.
In some cases, patients are given relaxing medication to reduce anxiety and enable a training effect through their own breathing.
Weaning is not successful for all patients. Around one percent of those affected are permanently dependent on artificial respiration because breathing can no longer be restored.
This is the case when the lungs or other respiratory organs are permanently damaged. In this case, weaning is used to reduce artificial respiration to a necessary minimum.
Ventilation methods that the patient can use at home are then used. The aim is to achieve the greatest possible independence for the patient.
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