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Old 09 October 2007, 22:58   #1
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Default How long can you stay on a ventilator for ?

is there a fixed amount of time, ie only a certain amount of oxygen you can take from a ventilator

A long story short, a very old close friend of the family (been my parents friends for the last 50 years, and known me for 39 years) is in hospital and has been for nearly a week and cannot breathe unaided at all and is on a ventilator

Tonight his wife has been told to come back into the hospital as they are turning the ventilator off, something to do with the amount of oxygen he is getting and the body can only take so much

the Hospital dont know what is wrong with him, other than say its something bronchial, something pneaumonia, something viral yet cant work it out what is wrong so they sedated him last week and kept him sedated and do not want him to try and breathe on his own as he is too ill, so are helping him breathe

He has also contracted MRSA after only being in the hospital for a couple of days, and this is supposed to be a state of the art hospital too

No one seems to know what the implications of the ventilator being turned off, his son is incredibly angry and asking lots and lots of questions but never really been given any straight answers

There is a possible hint that the apparent lack of care/diagnosis etc etc is due to him being a smoker too

Are they just now trying to free up a bed, or is there some truth to this ventilator and oxygen business

not a good day for a birthday
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Old 10 October 2007, 01:06   #2
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googled

Outcomes of long-term ventilator patients: a descriptive study -- Douglas et al. 6 (2): 99 -- American Journal of Critical Care

http://www.thoracic.org/sections/edu...s/mechvent.swf

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Old 10 October 2007, 01:13   #3
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Thanks Simon

We have reaslised it doesnt look good

The Doctor said his oxygen level was 90/95 and then went to 80/85 but said it needs to be 50 at the very most and his body cant really take the level that is being given

I think (as we havent heard back this evening) that his wife was called back to the hospital to make the descision to turn the Ventilator off, that does seem to be the gist of things

However there does seem to be a large negliegence part that has taken place here too from the Hospital side of things

He was left on general ward for far too long having crap (infection taken off his lungs in the ward, when he should have been in ICU, he did eventually get moved to IC once he had deteriated that bad that they had no choice

Like I say it isnt looking good, and chances are as soon as the Ventilator is turned off (may have already) he will be unable to breathe and probably pass away in minutes (if that)
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Old 10 October 2007, 01:19   #4
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I am assuming they wouldn't just turn it off and walk away.. surely they would monitor and turn it back on etc? no idea though
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Old 10 October 2007, 01:41   #5
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I think that is why his wife has been called back to effectively make the desicion

I know they cant just turn off the ventilator, if they do turn it off, they wont be monitoring to turn it back on again, it will be off for good

He simply cannot breathe unaided at all, but some of the details are very sketchy, and probably wont know any more until tomorrow
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Old 10 October 2007, 02:14   #6
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You can overdose on oxygen too.
The body is designed for 21% not 95%
It ends up breaking down the cells of the lungs as they cannot cope with that much oxygen

As a diver in an emergency I'm trained to give O2 and you have to give a certain amount of "air" breaks in between
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Old 10 October 2007, 02:19   #7
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Found this on Wiki,

At sea-level, 0.5 bar is exceeded by gas mixtures having oxygen fractions greater than 50%. Lung oxygen toxicity damage-rates at sea-level pressure rise non-linearly between the 50% threshold of toxicity, and the rate of damage on 100% oxygen. For this reason, intensive care patients requiring more than 60% oxygen, and especially patients at fractions near 100% oxygen, are considered to be at especially high risk, since if the situation is not corrected, the treatment may begin to cause lung damage which contributes to need for the high-oxygen mixture.
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Old 10 October 2007, 09:37   #8
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Sonic, just spoke to my wife and she thinks you've got the wrong end of the stick somehow. They can easily adjust the amount of oxygen he's getting on the ventilator.

They'll only turn it off if he's ready to breathe for himself, or if he's already gone. I hope it's the former. If so, switching it off will be a gradual process until his own breathing kicks in.
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Old 10 October 2007, 10:53   #9
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could very well be wrong end of stick, my dad was similar about 6 yrs ago

He had fallen down stairs and broken some ribs, upshot was his health wasnt very good anyway and he was put in the ICU at warrington. He also had to be sedated and put on a ventilator he needed this to save his life. After a good few days when he had made some improvements/body got stronger etc we had to make the decision to wean him off the ventialtor to see if his body could take over the normal function again.

Hopefully this is what the hospital means and everything turns out okay
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Old 10 October 2007, 11:04   #10
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Hi Sonic...

I am sure you will find that either he is ready to breathe on his own, or that the doctors are of the opinion his long term outlook is is such that keeping him on the ventilator is only prolonging the inevitable.

Hope all goes ok for him.
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Old 10 October 2007, 11:12   #11
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Sonic, you've got things very mixed up I'm afraid with all the numbers higgly piggly (obviously you are upset)

Though high concentrations of 02 are not good for you (they are toxic to the lungs) they can be used for as long as needed to try and maintain an adequate amount of o2 in the blood (and hence your organs)
What the Drs probably mean is that the fact your friend NEEDS so much o2 to try and achieve this implies his lungs are in a bad way and perhaps not improving. I think they are trying to hint that your mate is not going to get better and may well die (sorry to be blunt)
But there is no specified time that high concs of 02 can be administered for, I hope that makes sense?

The real question is how sick is he?

How much support is he needing for his lungs (how much pressure, how much 02 etc)
Have any other organs failed?
What was he like before? ie runs 5 miles everyday or can't climb a flight of steps?

If they say he is requiring loads of support for his lungs and then talk about switching the ventilator off then I'm afraid what they mean is withdrawal of treatment with death as a consequance.

Having spent more years than I would care to mention on ITUs I can tell you that sometimes we try for too long on futile cases and sometimes we pull out a little too early ( ie someone has 99% chance of death so pull out, but 1% will be the miracles that survive. If it was me I'd quite like even that 1% chance)

All the best, feel free to pm me and I'll try and help
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Old 10 October 2007, 11:30   #12
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Good reply DS
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Old 10 October 2007, 12:23   #13
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Quote:
Originally Posted by Fuzz View Post
You can overdose on oxygen too.
The body is designed for 21% not 95%
It ends up breaking down the cells of the lungs as they cannot cope with that much oxygen

As a diver in an emergency I'm trained to give O2 and you have to give a certain amount of "air" breaks in between
We used to breathe oxygen at 100% when flying at very high level and if we had a pressurisation failure we would be pressure breathing at 100% until we had descended to lower level.

This of course is to maintain the required partial pressure of oxygen in the lungs since the pressurisation in the aircraft was low.

Les

Last edited by Leslie; 10 October 2007 at 12:26.
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Old 10 October 2007, 12:36   #14
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Thanks very much DS

The Ventilator was brought in as he could no longer breathe on his own, the figures I got from my mum last night, and from what the Doc said, is that he is getting too much oxygen which isn't helping him as he isnt breathing on his own, and they have also said that they dont want him breathing on his own as he is too weak and too ill to do so

He went in because he was struggling with breathing due to infection/build up on the lungs, and was left on a normal ward for several days, whilst they just monitored him and he contracted MRSA

He has been on some Chemo drugs (not chemo itself as such) to help with another problem that he had, so his immune system has been quite low to begin with

He also has angina, and is diabetic too

I havent heard anything this morning yet, but things all do some very confusing especially to his immediate family as they cant understand what is happening, and feel like the Doctors aren't giving them all the right information

Since going into hospital he has deterioted so rapidly I think It has been a week since going on the ventilator, the antibiotics havent worked, and nothing upto now has done anything at all to improve the situation only worsen it
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Old 10 October 2007, 13:52   #15
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Can't say how sorry I feel for him, seems like everything has gone wrong for him from the outset.

I hope that he improves whatever happens.

Les
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Old 10 October 2007, 16:30   #16
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Thanks everyone for your comments, and information

I got a text a bit back to say that the Hospital were going to try some different drugs to see if it helps

He sadly passed away at 2.45 this afternoon

RIP Peter
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Old 11 October 2007, 10:12   #17
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Quote:
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Thanks everyone for your comments, and information

I got a text a bit back to say that the Hospital were going to try some different drugs to see if it helps

He sadly passed away at 2.45 this afternoon

RIP Peter
Sorry to hear that. Its academic now but I think what you were talking about when you said 'drs said too much 02 wasn't helping him breathe' is called hypoxic drive. You and I depend on raised c02 to stimulate us to breathe. For long term smokers where the c02 gets raised chronically, low 02 takes over as the drive ie hypoxic drive. If you then give too much 02 you take that drive away and they breathe less.

Sorry again
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Old 11 October 2007, 11:48   #18
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Thanks DS

I found out last night what my Mum was referring to was the level in perecentage of oxygen he was recieving, ie 90/95%

He passed away on the Ventilator and peacefully as he essentially shut himself down and gave up the fight

Im not sure as to what the exact cause of death was, pneumonia & mrsa I think, but the family have decided not to have a post mortem
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Old 11 October 2007, 12:32   #19
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My commiserations.

Les
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Old 11 October 2007, 12:32
 
 
 
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