How does breathing support work in the ICU?

An intensive care unit (ICU) is a part of the hospital where very sick people get care. One reason a person might be in an ICU is for trouble breathing. The ICU has special equipment to help people breathe. The doctor may use different equipment depending on how hard it is for the person to breathe.

• A ventilator is a machine that breathes for a person while the lungs are healing. It sends oxygen or air into the lungs through a thin tube and allows carbon dioxide to escape. The tube is placed in the windpipe through the nose or mouth. If the person needs the ventilator for a long period of time, the surgeon may place the tube in an opening made directly into the windpipe through the neck. This is called a tracheostomy, or "trach" (say "trayk") tube. The tube is placed in the opening.
• A continuous positive airway pressure (CPAP) machine may be used when a ventilator isn't needed. It gently pushes oxygen or air into the lungs through a mask over the nose or mouth. People can breathe on their own with this extra help.
• A nasal cannula is a device with two prongs that are placed in the nostrils when a person just needs more oxygen. The oxygen goes through the tubes and into the nostrils.
• Oxygen may also be given through a mask. Oxygen flows through a tube and into a mask that is placed over the nose and mouth.

The equipment that helps a person breathe may need to be adjusted a lot. If you have questions about breathing support, ICU staff can help explain the different types of equipment and how they work.

The ICU staff can use other devices to track breathing.

• A heart monitor has a sensor that attaches to the chest to track heart rate.
• A pulse oximeter clips to the end of the finger. It measures how much oxygen is in the blood.
• An arterial line is a thin, flexible tube that is placed into an artery. This line is usually placed in the wrist or groin. It can take blood samples to measure the oxygen and carbon dioxide in the blood. (It can also measure blood pressure.)

What can you expect in the ICU?

Over time, people in the ICU may not need as much breathing support. As a person gets stronger, the doctor may move (or wean) him or her from a ventilator to a CPAP machine, then to a mask or nasal cannula with oxygen, and finally to breathing without the need for help.

You may see tubes and wires attached to the person. This can be scary to see. But these things help the doctor treat the person. The tubes supply air, fluid, and medicines. The wires are attached to machines that help the doctor keep track of vital signs. These include temperature, blood pressure, breathing rate, and pulse rate.

Ventilators and other equipment have alarms that alert the care team to any sudden changes. Often an alarm is not a reason for concern, but the care team may come in and check an alarm. If you have questions about any alarms, you can ask an ICU staff member.

The ICU staff is highly trained to care for very sick people. They will do everything they can to help. If you need it, ask for support from friends and family. You can also ask the hospital staff about counselling and support.