Q: A member of our church was put on a ventilator after an accident. They told us he is now on ventilator weaning. What does this entail and why is it necessary?
A: Whenever our body requires an increase in breathing effort, whether from exercising, nervousness, or illness, that increase in effort can cause a tremendous amount of stress on the body and potentially cause respiratory failure. The actual act of breathing requires an extensive amount of energy and is often something we take for granted. If an increased effort in breathing is coupled with other medical problems (e.g., pneumonia, COPD, increased fluid, decreased blood pressure, etc.), respiratory fatigue can occur. This is somewhat similar to a runner who becomes exhausted during a race because their body is not conditioned. When we can no longer efficiently breathe on our own, this can cause respiratory failure or near failure and a mechanical ventilator is required. On a ventilator, the body rests the breathing muscles while the machine does most of the work, allowing time for recovery. However, as patients recover and begin to try breathing on their own again, these muscles need retraining. “Weaning” is the process of slowly retraining and reteaching the body how to breathe efficiently without the help of a machine. Just as it takes time to train for any physical activity, our body has to “train” or “learn” how to breathe with no assistance. The weaning process allows for a controlled, slow, and supervised environment where medical staff can monitor how patients will react to the efforts of breathing on their own again.