If you are hospitalized for complications of your COPD, you may be given antibiotics (and other medications intravenously), have your blood oxygen level measured, have chest-x rays taken and several blood tests. These tests will help to guide your healthcare provider in how best to treat you. Sometimes, despite all treatment, the lungs are unable to adequately take in oxygen. In this case you may require help to breathe. You may be given oxygen through a nasal cannula (tube in your nose), through a loose-fitting mask over your nose and mouth, through a tight fitting mask, such as those used in non-invasive ventilation, or through a tube down your trachea (windpipe) and connected to a ventilator.
Will I require a breathing machine?
If you are unable to keep a safe oxygen level using a nasal cannula or loose-fitting oxygen mask, additional help to get oxygen into your system will be needed. This means a machine will be used to assist your breathing. The two types of breathing assistance are non-invasive ventilation and a ventilator.
Non-invasive ventilation is an approach to blow air into your lungs without having to put a tube into your trachea (intubation). A tight-fitting mask over your nose and/or mouth is used for a machine to blow air into your lungs. This additional air with oxygen may be just the help needed to bring your oxygen level back into the normal range. This type of ventilation can be done in a normal hospital room or in the intensive care unit.
A ventilator is a device used to control your breathing. In order for the ventilator to work, a tube must be put into the trachea. This tube can be an endotracheal tube, which is inserted into the nose or mouth, or a tracheostomy tube, which requires an incision into the neck. A ventilator is a machine that "breathes for you" by pushing air into your lungs, followed by a time for your lungs to empty. Other names for a ventilator are a respirator or breathing machine.
Some people with COPD develop severe pneumonias or other life-threatening conditions that prevent them from breathing normally. Ventilators are used in this case because the person either cannot breathe on their own or they have difficulty breathing effectively. The ventilator is a way of delivering oxygen, getting rid of carbon dioxide and making breathing more comfortable. A ventilator may only be required temporarily to assist with breathing. However, in some cases, the person may not ever be able to breathe without a ventilator, even after the pneumonia or other condition improves. Advanced directives are important because they provide "direction" to your healthcare provider regarding whether or not you want treatment with a ventilator.
What happens if my lung collapses?
With any lung surgery there may be a temporary collapse of the lung. A collapsed lung can be re-expanded by placing a tube into the chest to release the air. In some cases, even without surgery, COPD may lead to lung collapse from air escaping from the lung into the space surrounding the lung (that is, the air does not escape through the wall of the chest to the outside air, but stays inside the chest). For a small collapse, nothing needs to be done and the hole in the lung heals. A large collapse may require hospitalization and a chest tube will need to be inserted so the escaped air can be removed. A procedure, which may be done to keep the lung from collapsing again, is scarring of the sac covering the lung (called pleuridesis). This is done if the lung repeatedly collapses or does not re-inflate with the chest tube.
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