Mechanical ventilation means having a machine help you
breathe. If you have
COPD, you may need this treatment when your breathing
problems suddenly get worse and stay worse. These breathing attacks are called
COPD exacerbations or flare-ups.
treatment is usually used until you are able to breathe better. In rare cases,
it is used as long-term therapy in your home or a care facility.
There are two kinds of ventilation:
- Noninvasive: Nothing is
inserted into your mouth or throat.
- Invasive: A breathing tube is inserted into your
The full name for this is noninvasive positive-pressure ventilation,
sometimes shortened to NPPV. A machine pushes air into your lungs through a
mask that covers your nose or your nose and mouth.
generally is recommended when you're having a very hard time breathing because
of a COPD attack and sudden lung failure.1, 2
Studies show that this treatment:1, 2
- Can shorten hospital stays.
more people survive in the hospital.
- Makes it less likely that you
will need a tube inserted into your windpipe.
But studies also show that people with only mild COPD attacks
aren't helped by this treatment.1
not clear whether this treatment helps people with severe stable COPD. Studies
have shown conflicting results. Some research shows a possible positive
benefit. Other research shows no benefit.3 More study
needs to be done.
People who have very low
blood pressure, are not breathing on their own, and
are not fully able to think and interact with caregivers are not considered
good candidates for this treatment. For them, invasive mechanical ventilation
is considered safer.
In invasive mechanical ventilation, a breathing
tube is inserted into your windpipe, and a machine forces air into your lungs.
Although this can save your life during a COPD attack, it doesn't
always help. Consider talking with your doctor and your family ahead of time
about what kind of treatment you want.
- You will probably need pain medicine and a
sedative to calm you. You may occasionally need drugs
to paralyze the respiratory muscles so that the machine can do its
- The medicines make it hard for you to communicate with
caregivers. And they can have harmful effects on your blood pressure and bowel
- The treatment can make you more likely to have a
collapsed lung, in which there is air in the chest that is outside of the lung.
- You have a higher risk of a type of
pneumonia called ventilator-associated pneumonia. The
breathing tube may interfere with how your body works to prevent pneumonia.
This type of pneumonia is more likely to be caused by bacteria that are
resistant to antibiotics. That makes it hard to treat. There is less risk of
getting this pneumonia with noninvasive ventilation.
- Although it's
rare, breathing tubes can harm the vocal cords or the windpipe.