Ventilators are machines that blow air—or air with extra oxygen—into your airways and your lungs. Your airways are pipes that carry oxygen-rich air to your lungs when you breathe in. They also carry carbon dioxide (a waste gas) out of your lungs when you breathe out.

To learn more about your airways and lungs, visit our How the Lungs Work Health Topic.

The ventilator

A ventilator uses pressure to blow air—or air with extra oxygen—into your lungs. This pressure is known as positive pressure. You usually breathe out the air on your own, but sometimes the ventilator does this for you too.

A ventilator can be set to "breathe" a set number of times a minute. Sometimes it is set so that the machine only blows air into your lungs when you need it to help you breathe.

Before your healthcare team puts you on a ventilator, they may give you:

Fluids and other medicines through your vein (via IV) to help keep oxygen-rich blood flowing to your organs

Medicines to make you sleepy and to stop you from feeling pain

Oxygen through a mask

There are several ways to get air from the ventilator into your lungs. You may wear a mask or helmet, or you may need a breathing tube.

Ventilation with a face mask or helmet

You may wear a face mask or helmet to get air from the ventilator into your lungs. This is called noninvasive ventilation. The face mask fits tightly over your nose and mouth to help you breathe. The helmet fits over your head. Your doctor may recommend this method if your breathing problems are not life-threatening or to help you get used to breathing on your own after your breathing tube is removed.

There are some benefits to this type of ventilation.

It can be more comfortable than a breathing tube.

It allows you to cough.

You may be able to talk and swallow.

You may need less sedative and fewer pain medicines.

It lowers some risks, such as pneumonia, that are associated with a breathing tube.

Ventilation with a breathing tube

In more serious cases or when non-invasive ventilation is not enough, you may need invasive ventilation. Here, a breathing tube is placed into your windpipe, and the breathing tube (also called an endotracheal tube) is connected to a ventilator that blows air directly into your airways. The process of putting the tube into your windpipe is called intubation.

Usually, the breathing tube is inserted into your nose or mouth. The tube is then moved down into your throat and your windpipe. The endotracheal tube is held in place by tape or a strap that fits around your head.

This procedure is often done in an operating room while you are under anesthesia. In emergencies outside the operating room, you will receive medicine to make you sleepy and prevent the pain and discomfort that occurs when a breathing tube is being inserted.

Watch this video to learn more about this process.

This animation shows how intubation works. Doctors use a special instrument to guide the endotracheal tube down through your mouth, down into your airways. Medical Animation Copyright © 2020 Nucleus Medical Media, All rights reserved.

If you need to be on a ventilator for a long time, the breathing tube will be put into your airways through a tracheostomy. Your doctor will use surgery to make a hole through the front of your neck and into your windpipe. The tube that is put into the hole is called a "tracheostomy" or “trach” tube. The tracheostomy procedure is usually done in an operating room or intensive care unit. Your doctor will use anesthesia, so you will not be awake or feel any pain. The trach tube is held in place by bands that go around your neck.

Both types of breathing tubes pass through your vocal cords. You can’t talk with an endotracheal tube and it will be difficult to talk with a trach tube unless it has a special speaking valve attachment. For the most part, endotracheal tubes are used for people who are on ventilators for shorter periods. If you need to be on a ventilator for a longer time, your doctor can replace the endotracheal tube with a trach tube, which is more comfortable for people who are awake.