Intubation involves the insertion of a thin tube, called an endotracheal tube, through the mouth into the airway. This procedure connects the patient to a ventilator, a device that assists or takes over the process of breathing. Intubation is performed in situations where the patient requires anesthesia, sedation, or respiratory support due to a severe medical condition. It is a common medical practice today for maintaining adequate oxygen supply and airway control.
What Does “Being Intubated” Mean?
The term “intubated patient” has become widely recognized, prompting questions such as, “What does intubation mean, and why are patients intubated?” An intubated patient refers to someone who has undergone the intubation process to receive respiratory support. This is usually necessary for individuals who cannot manage their airways or breathe unassisted.
Why is Intubation Necessary?
Patients may require intubation during surgeries, especially under general anesthesia, since the drugs used affect all muscles, including the diaphragm, making independent breathing impossible. In most cases, the endotracheal tube is removed after surgery when the anesthesia wears off, allowing the patient to resume normal breathing.
However, in cases involving major surgeries like open-heart procedures or serious respiratory conditions, the tube may remain in place longer, with the patient breathing through a ventilator.
Intubation is also required in cases of respiratory failure caused by conditions such as:
- Severe lung injury
- Pneumonia
- COVID-19
How is Intubation Performed?
Before the procedure, the patient is typically under anesthesia or sedation, or unconscious due to illness, which facilitates easier access to the airway. The patient is laid flat on their back, and the clinician, positioned at the patient’s head, gently opens the mouth and advances a tube using a tool equipped with light. Pressure is applied to the tongue to prevent airway obstruction, and the tube is carefully inserted into the airway. To confirm proper placement, the clinician listens to the patient’s lungs using a stethoscope.
In some cases, nasal intubation (using a nasotracheal tube) may be performed, especially when oral access is restricted. Pediatric intubation follows the same principles but requires smaller instruments due to children’s narrower airways.
Extubation and Recovery
Once the patient no longer needs intubation, the tube is removed through a process called extubation. The balloon securing the tube is deflated, and the tube is gently withdrawn. The patient is then closely monitored for any respiratory distress, which may necessitate additional oxygen support.
Risks of Intubation
While intubation is often necessary to save lives, it carries some risks, especially if the procedure is prolonged:
- Injuries to the teeth, tongue, throat, or larynx
- Insertion of the tube into the esophagus instead of the trachea
- Tracheal injury
- Bleeding or aspiration (inhalation of fluids or food into the lungs)
- Pneumonia or lung infections
Nutrition During Intubation
For short procedures, no special feeding is required, but for extended intubation, nutrition is provided via intravenous (IV) fluids or a feeding tube. Feeding can be done using orogastric (through the mouth) or nasogastric (through the nose) tubes. These methods ensure that the patient receives necessary nutrients while intubated.
Intubation, despite its risks, is a critical medical procedure, often used to address respiratory issues caused by diseases like pneumonia, COVID-19, or chronic obstructive pulmonary disease (COPD). It ensures that patients in respiratory distress receive adequate oxygen and airway management, essential for survival in severe cases.