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Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can peace of mind, have real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of “your questions answered” and in last week’s episode I explained

“How long can my critically ill loved one stay on an Intra-aortic balloon pump(IABP)?”

You can read, watch or listen to the article here.

In this week’s episode of “your questions answered” I want to answer another very important and frequently asked question of our readers at INTENSIVECAREHOTLINE.COM and the question that I want to answer this week is

“How long does it take for my critically ill loved one to be taken off the ventilator and have their breathing tube/ endotracheal tube removed?”

If your loved one has been admitted to Intensive Care for critical illness, chances are that he or she requires mechanical ventilation and therefore has a breathing tube(endotracheal tube) in their throat that is attached to a ventilator.

Most critically ill Patients in Intensive Care require invasive(with a breathing tube/ endotracheal tube) or Non-invasive ventilation(also BIPAP or mask ventilation) during their stay in Intensive Care.
Therefore, the question arises of how long it takes before the breathing tube(endotracheal tube) can be safely removed. Removing the breathing tube is also known as extubation.

And just to quickly clarify, this blog is not about weaning from a ventilator with Tracheostomy. There are other articles that relate to weaning from the ventilator with Trachesotomy and I have put links to those articles at the end of this blog.
So let’s just quickly look at what may lead to your critically ill loved one requiring a breathing tube or endotracheal tube and mechanical ventilation.

The most common scenarios leading to mechanical ventilation are
• Admission to Intensive Care after surgery- many types of surgery that require admission to Intensive Care require a Patient to be ventilated. The most common ones are Aortic Aneurysm Repair, CABG, heart transplant, lung transplant, liver transplant
• Induced coma
• Multi Trauma including Head and brain injuries
• Ventilation and breathing difficulties like in Asthma, COPD, Pneumonia, lung failure(ARDS)
• Other states of unconsciousness caused by Cardiac Arrest or seizures

Those are the most common scenarios leading to mechanical ventilation and a breathing tube/endotracheal tube in Intensive Care and the list is not exhaustive.
As a rule of thumb, mechanical ventilation and a breathing tube/ endotracheal tube should always be a temporary treatment and not a permanent one.

Therefore, the goal is to have the breathing tube(endotracheal tube) removed as quickly as possible, as there are complications associated with mechanical ventilation.

Recommended resources:

• THE 7 ANSWERS TO THE 7 MOST FREQUENTLY ASKED QUESTIONS IF YOUR LOVED ONE REQUIRES ONGOING MECHANICAL VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE!

• FOLLOW THIS PROVEN SYSTEM TO AVOID THE 3 MOST DANGEROUS MISTAKES YOU ARE MAKING BUT YOU ARE UNAWARE OF, IF YOUR LOVED ONE REQUIRES LONG-TERM VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE!

• AVOID MISTAKES YOU ARE MAKING AND DOING THE RIGHT THINGS WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

“As quickly as possible” generally means within a few days at the most or a 24-72 hour time span

Lets quickly look at the major indications for mechanical ventilation and a breathing tube(endotracheal tube) and how long it normally takes to remove the breathing tube/ endotracheal tube

• After surgery: the breathing tube/endotracheal tube after surgery should be removed as quickly as possible. Again as a rule of thumb, after Cardiac Surgery(CABG), Aortic Aneurysm Repair, Heart transplant, lung transplant, liver transplant within less than 24 hours, unless there are complications. All organ transplants have a high risk of complications associated and therefore ventilation might be required for more than 72 hours

• After an Induced Coma the ventilator and breathing tube should be removed as quickly as possible, however “waking up” after an Induced Coma can take significant time and longer than expected and therefore a delay in taking the breathing tube out is not uncommon. Related Article: What could be the cause if my critically ill loved one is removed from an induced coma but still hasn’t woken up? https://intensivecarehotline.com/what-could-be-the-cause-if-my-critically-ill-loved-one-is-removed-from-an-induced-coma-but-still-hasnt-woken-up/

• Multi Traumas and Head Injuries can be more challenging situations and therefore may require for your critically ill loved one to be ventilated for more than 72 hours. Some cases may be ventilated for 7- 10 days before having the breathing tube removed. There is also an increased chance for your critically ill loved one requiring a Tracheostomy.

• Ventilation difficulties and issues like in Asthma, COPD, Pneumonia shouldn’t require more than 72 hours of ventilation as well, however it depends on other medical issues as well. Again, medical issues associated with breathing like in Asthma, COPD or Pneumonia should give the lungs a rest during ventilation and once recovered the breathing tube/endotracheal tube should be removed as quickly as possible.

• lung failure(ARDS) is more complicated and challenging and many Patients going through lung failure may require a Tracheostomy. Lung failure(ARDS) very rarely tends to be straightforward and therefore often requires prolonged mechanical ventilation.

• Cardiac Arrest situations often require mechanical ventilation and an Induced coma as well. Especially after Cardiac Arrest situations, your critically ill loved one may require “cooling” for 24 hours as treatment of choice and therefore mechanical ventilation may last up to 72 hours or even longer.

• If your critically ill loved one had Seizures they often require mechanical ventilation, a breathing tube and an Induced Coma as well, in order to protect the brain from having ongoing seizures and furthermore, Seizures often cause vomiting and therefore aspiration of stomach content into the lungs. The breathing tube tends to protect the lungs from aspiration of stomach contents. Aspiration can also cause Pneumonia. Again, as a rule of thumb, after the seizures have ceased and are controlled by medications, there should be no reason to keep your critically ill loved one ventilated and extubation(removal of the breathing tube) should be the aim within less than 72 hour

I described the most common scenarios here in Intensive Care that require ventilation and a breathing tube and I have given you time frames for how long it takes for your critically ill loved one to be taken off the ventilator.
Keep in mind that each case is different and individual and the advice given is general advice only.

If again, your critically ill loved one is ventilated for more than one week, there is an increased chance that your loved one may require ongoing ventilation with Tracheostomy and I have put links to related Articles about Tracheostomy and ventilation below, at the end of the article.

In any case, if your loved one is critically ill in Intensive Care and requires ventilation with a breathing tube and has been placed in an induced coma, chances are that you are out of your comfort zone and that you feel stressed, vulnerable, frustrated and overwhelmed by the experience of having your loved one critically ill in Intensive Care! It’s good that you are seeking help and independent advice, because unless you have done your own research, you should always question the Intensive Care team’s approach, because if you don’t question, you have no power, no control and no influence! The consequences of having no control, power or influence is that the Intensive Care team can drive their own agenda and their agenda may not be in the best interest of your critically ill loved one and your Family.

I have learned this in more than 15 years Intensive Care nursing experience whilst working in three different countries around the world! You’d be surprised of how much goes on behind the scenes with the only purpose to keep you and your Family at arm’s length and the Intensive Care team has no interest in letting you see behind the scenes and the Intensive Care team doesn’t want you to have control, power and influence!

How do you get to that all important feeling of control, power and influence whilst your loved one is critically ill in Intensive Care?
You’ll get the important feeling of control, power and influence by downloading your FREE “INSTANT IMPACT” Report by entering your email below now!

In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care!
In your FREE reports you’ll also discover

• How to ask the doctors and the nurses the right questions
• Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
• How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
• 5 “killer” tips& strategies helping you to get on the right path to PEACE OF MIND, control, power and influence in your situation
• You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
• How to stop being intimidated by the Intensive Care team and how you will be seen as equals
• You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
• How you need to manage doctors and nurses in Intensive Care(it’s not what you think)

Thank you for tuning into this week’s “your questions answered” and I’ll see you again in another update next week! Make sure you also check out our “blog” section or send me an email to [email protected] with your questions!

Also check out our Products section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 consulting!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!

Sincerely,
your Friend
Patrik Hutzel