Podcast: Play in new window | Download

Subscribe: Apple Podcasts | RSS

Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, first of all, I want to thank all of you who keep the questions coming so that I can keep making those videos, but I have so much to share whether it’s the questions that keep coming or when we work with clients one on one.

Today, I have a quick tip here, and the quick tip today is about, “How is the ventilator controlling the blood pressure?” That’s a question from a reader. It’s a very broad question and whilst the ventilator is generally speaking, not controlling the blood pressure, it certainly can contribute to affect the blood pressure and that is predominantly by patient discomfort.

So if your loved one is on a ventilator with a breathing tube, it can be extremely uncomfortable. So then you could have a patient responding with high blood pressure because of the distress. If that is the case, then you need to sedate a patient with propofol or midazolam/Versed sometimes with Precedex.  Often, you also need to add in an opiate, or painkillers such as morphine or fentanyl.  So, that is one way how blood pressure can be affected.

Another way that blood pressure can be affected with the ventilator is, really when patients get into an induced coma because of the intubation and the breathing tube in the throat. Their blood pressure goes down if anything because of the induced coma, the side effect from the medication that I just mentioned, propofol, midazolam or Versed, fentanyl or morphine is often low blood pressure or hypotension.

Then if it’s getting too low on the other end, you need inotropes or vasopressors that maintain medically a blood pressure that is compatible with life because blood pressure sometimes can really plummet when it’s to dangerously low levels when someone is being put on a ventilator.

Also, when someone is on a ventilator with a breathing tube, they also have something that’s called a PEEP. PEEP stands for Positive End Expiratory Pressure. And it ensures that at the end of expiration, the lungs don’t collapse because when someone is ventilated, the risk of the lungs collapsing is very high because it’s actually positive pressure in the lungs versus negative pressure when someone is spontaneously breathing.

So, the PEEP can also have a negative impact on the blood pressure. It can, again, can either go up or down. Again, it depends a little bit on, how a patient is responding, but one way or another PEEP can be very uncomfortable. So people can, may respond with high blood pressure because of stress. But PEEP can also impact on hypotension. So the blood pressure can also go down when the PEEP is high because of the impact it has on the heart.

So one way or another, it’s not the ventilator as such, that’s contributing to high or low blood pressure. But what does happen is the whole effect of being ventilated with the induced coma, with the PEEP, with the sedatives with the opiates that can have an impact on high or low blood pressure.

So whoever asked this question, I can’t remember, it has a point that it does impact on the blood pressure but it’s not actually controlling it, definitely not controlling it. If anything, it makes it actually volatile, definitely doesn’t control, it’s actually a volatile situation.

And for many patients in intensive care, of course, the situation can be volatile because it’s just very unpredictable. So, I hope that explains how ventilation does not control blood pressure but how it can impact the blood pressure. That’s really the purpose of this video, how it impacts on the blood pressure with a high or low blood pressure.

So, thank you so much for watching.

Now, if you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There you have access to me and my team 24 hours in a membership area and via email, and we answer all questions, intensive care related.

I also offer 1:1 consulting and advocacy for families in intensive care. I talk to you to your families. I talk to doctors and nurses directly. I can represent you in family meetings with intensive care teams and so forth.

We also offer medical record reviews in real-time. If you need a second opinion in real time, please contact us as well.

And if you need a medical record review after intensive care because you have unanswered questions, you need closure or you are simply suspecting medical negligence, please contact us as well.

Thank you so much for watching.

Subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families and comment below what you want to see next or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com, and I will talk to you in a few days.

Take care for now.

Related Articles:

Quick Tip for Families in Intensive Care: How to Avoid LTAC or Subacute! Quick Tip for Families in Intensive Care: 3 signs that ICU is Preparing your Loved One for LTAC! Quick Tip for Families in ICU: How to Get Information About My Dad, Doctors Aren’t Returning Calls! Quick Tip for Families in ICU: Not Knowing if My Wife Can Get Off the BIPAP Machine in ICU? Quick Tip for Families in Intensive Care: Is My Mother in ICU “Unweanable”?