The most intensive form of ventilation is so extremely unpleasant that patients are usually kept sedated for the whole thing.
An external pump shoves air into the lungs via a tube through the mouth and down the windpipe; there's a very small window of pressures where you can do this without physically damaging the lung. The tube itself is immensely uncomfortable and I imagine its mere presence would be traumatic enough even if your life were not at risk (for example, you can't speak because it sits against the vocal cords).
The muscles that normally cause you to breathe are completely inactivated chemically during ventilation, and this can cause them to atrophy.
Furthermore most people, certainly before covid, who are so ill wouldn't even be considered for ICU respirator use because the recovery time from the trauma to keep them alive might exceed their likely life expectancy anyway. There is a worry that during covid more people are being referred for respiraton when previously they wouldn't be.
That was the issue, at least in the UK with the field hospitals as well. They couldn't handle patients with multidisciplinary issues and so were utterly pointless under generally applied ICU practices.
Language differences really don't make this easy. For example, in Polish "respirator" means ventilator and "wentylator" means fan (like the kind you'd put on your desk on hot days).
I had one of those in my trachea in 2 different occasions, sedated the whole time like you said.
For very few moments I was a bit lucid and I detected the foreign object. But you cannot move, you can barely move your eyes. I fought against it with my tongue and it was problematic so the nurses had to rush to sedate me a bit more, but you know that something is going on; you can hear some beeps and rushed steps around you. For a few short moments your brain is thinking about possibilities. You ask yourself if maybe you are in a comma, or in a vegetative state. And you get really sad. I remember crying while going back into sedation, terrified and in despair. And I was just 14 and 16 years old.
For me, having that ventilator -something that when you read about it, or you talk about it, doesn't seem like much- was a traumatic experience that I will never forget.
An external pump shoves air into the lungs via a tube through the mouth and down the windpipe; there's a very small window of pressures where you can do this without physically damaging the lung. The tube itself is immensely uncomfortable and I imagine its mere presence would be traumatic enough even if your life were not at risk (for example, you can't speak because it sits against the vocal cords).
The muscles that normally cause you to breathe are completely inactivated chemically during ventilation, and this can cause them to atrophy.
There's a pretty good set of diagrams at https://eu.usatoday.com/in-depth/news/2020/04/10/coronavirus... .
reply