Breathing machine (ventilator) (Mechanical ventilation / breathing support)

What is mechanical ventilation (a breathing machine)?

Mechanical ventilation means using a machine called a ventilator to breathe for a person, or to help their own breathing, when they cannot breathe well enough on their own. It is one of the main types of support given in an intensive care unit, so this guide is written mainly for the family and friends of someone who is on a ventilator.

The ventilator is connected to a tube that passes through the mouth (or sometimes the nose) into the windpipe — this is called intubation, and it is done under sedation or anaesthetic so the person does not feel it. The machine gently blows oxygen and air into the lungs and helps remove carbon dioxide. Because having a tube in the windpipe is uncomfortable, people are usually kept sedated (in a sleep-like state) while it is in place.

People need a ventilator for many reasons — a severe chest infection or pneumonia, after major surgery, after a serious accident, or when another illness is so severe that breathing is affected. Some need it for only a short time; others for days or weeks.

A breathing machine buys time and supports the lungs while the illness is treated. It does not cure the underlying problem by itself, and coming off it can take patience as the person's strength returns.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Invasive ventilation vs non-invasive support

Gentler mask support (see the non-invasive ventilation guide) is sometimes tried first or used to help wean off a ventilator, but is not suitable for everyone.

Preparing for your treatment

• Going on a ventilator is usually an emergency, so there is rarely time to prepare — this section is mainly to help families.
• Understand that sedation keeps the person comfortable and unaware of the tube; this is kind, not a bad sign.
• Agree one main family contact to ring the unit and update everyone else.
• Even when sedated, talking gently, holding a hand or playing favourite music may bring comfort — ask the nurses.
• Ask the team why the ventilator is needed, and what they hope it will achieve.
• Ask how weaning (coming off the machine) usually works and what it depends on.
• Look after yourself — recovery can be long, and you will be needed.

What happens

To start full breathing support, the team gives sedative and other medicines and places a tube through the mouth into the windpipe (intubation). This is done quickly and carefully, and the person does not feel it. The tube is connected to the ventilator, which is set to deliver the right amount of oxygen and breaths for that person, and the settings are adjusted as their lungs respond.

While the tube is in place, the person is usually kept sedated and cannot talk or eat normally; feeding is given through a fine tube into the stomach. Nurses regularly clear secretions, care for the mouth, and reposition the person to protect the skin and lungs.

As the illness improves, the team begins weaning — gradually reducing sedation and letting the person do more of their own breathing while the machine does less. When they can breathe well enough on their own, the tube is removed (extubation). Some people have a short period of gentler mask support afterwards.

If a ventilator is likely to be needed for more than a few days, a tracheostomy (a tube through the front of the neck) may be done, which is often more comfortable and can make weaning and waking easier.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Most risks come from how severe the underlying illness is rather than the machine itself, and the team uses careful settings and infection-prevention to reduce harm. Weaning can be quick or can take weeks, and setbacks are common and do not mean the team has done anything wrong. Ask what is limiting weaning and what the plan is.

Published figures to discuss

How long someone needs a ventilator, and whether complications occur, depends heavily on the illness, the person's lungs and health beforehand, and how long they are critically ill. Because of this, no single figure applies to everyone. Recognised risks include chest infection on the ventilator, muscle weakness from being still, and delirium, but their likelihood varies. Your team's day-by-day view of weaning and recovery is more useful than a general statistic.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Coming off a ventilator is a step forward, but it is not the end of recovery. Breathing muscles, strength and energy take time to return, and many people feel weak and tired for weeks afterwards.

• A hoarse voice and sore throat for a while after the tube comes out
• Feeling very weak and breathless on effort as breathing muscles recover
• Tiredness, poor appetite and broken sleep for weeks
• Patchy or confusing memories of the time on the ventilator
• Needing physiotherapy and gradual exercise to rebuild strength

Aftercare

• Expect breathing strength and energy to return gradually — be patient with yourself.
• Do the breathing exercises and chest physiotherapy the team recommends.
• Build up activity slowly with help from physiotherapists.
• Eat well and rest to help the body repair after a serious illness.
• Talk about confusing or frightening memories; a patient diary can help make sense of them.
• Tell the GP or recovery team about persistent breathlessness, low mood or nightmares.
• Keep follow-up appointments, including any ICU recovery clinic and lung checks.

• One main family contact and unit phone number saved
• Glasses, hearing aids and dentures brought in
• A few familiar items or music for comfort
• Notebook or diary for news, questions and memories
• Understanding of how weaning is going and what it depends on
• Physiotherapy and breathing-exercise plan for recovery
• GP told once home, for ongoing breathing and recovery support

⚠ Get urgent help if…

• While in hospital, the team monitors breathing around the clock — you do not need to watch the machine yourself.
• After going home, seek urgent help (call 999) for sudden severe breathlessness, gasping, or blue or grey lips.
• Get same-day advice for worsening breathlessness, a high temperature with shivering, or coughing up discoloured phlegm — signs of a chest infection.
• If you had a tracheostomy, follow the specific advice given for caring for the site and when to seek help.
• Watch for a hot, swollen or painful calf, which can signal a blood clot.
• Get help for persistent low mood, nightmares or severe anxiety after critical care.

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is that the ventilator supports breathing long enough for the lungs and the underlying illness to recover, the person is gradually weaned off, and their breathing returns to a level that lets them recover and leave hospital.

Not everyone can be weaned quickly, and a few people, depending on how severe their illness is, cannot return to fully independent breathing. The machine supports the lungs but does not cure the cause by itself, and the team's day-by-day view is the most useful guide to progress.

How well breathing recovers depends mostly on the underlying illness and the person's lungs beforehand. Many people return to near-normal breathing as they recover, while others have longer-lasting effects, especially after severe lung illness. Breathing strength and stamina often continue to improve over many months with rehabilitation.

Related tests, treatments or support

Mechanical ventilation is usually one part of intensive care, used alongside sedation, blood-pressure support, and treatment of the cause such as antibiotics for infection (see sepsis management). Gentler mask support (non-invasive ventilation) is sometimes used before a tube, or to help wean someone off the ventilator afterwards.

Follow-up & long-term care

On the ward and after discharge, the team checks breathing, strength and recovery, arranges chest physiotherapy, and may arrange lung tests or a chest clinic if needed. People who had an intensive care stay may be offered a critical care follow-up clinic to help with physical and emotional recovery.

• Keep up breathing exercises and chest physiotherapy as advised.
• Build strength and stamina back gradually with help from the recovery team.
• Attend any lung or critical care follow-up appointments.
• Tell the GP about ongoing breathlessness, low mood or memory problems.

Repeat, follow-on and what comes next

• Weaning is often a stop-start process, and some people need several attempts before the tube can come out.
• Some people need a tracheostomy if a ventilator is needed for more than a few days.
• Occasionally the tube has to be replaced or breathing support restarted after a setback.
• Plans are reviewed daily; a slower wean does not mean the team has done anything wrong.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Careful sedation and a clear, regularly reviewed weaning plan.
• Chest physiotherapy and early movement to rebuild breathing strength.
• Honest family updates in plain English and a single point of contact.
• Swallowing and voice checks after the tube comes out, with speech and language therapy if needed.
• Support for the emotional after-effects of critical care, including patient diaries and follow-up clinics where available.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Mechanical ventilation is usually NHS-funded critical care, so most families will never see a bill for it.
• Where private critical care provides it, the length of time on the ventilator is a main cost driver.
• The intensity of intensive care around the ventilator (nursing, monitoring, sedation) adds to cost.
• Any extra procedures, such as a tracheostomy, add to cost.
• Drugs, scans, tests and chest physiotherapy are usually billed in addition.
• Rehabilitation and follow-up after coming off the ventilator also matter.

• For NHS care, there is no charge — ask about practical support such as travel and parking.
• If care is private, ask what the daily critical care fee covering ventilation includes.
• Ask whether consultant fees, drugs, procedures such as tracheostomy, and scans are billed separately.
• Ask what happens if a transfer to an NHS critical care unit becomes necessary.
• Ask how breathing rehabilitation and follow-up are arranged and funded.
• Ask who to contact about any insurance or billing questions.

On the NHS? Mechanical ventilation is provided by the NHS in critical care, usually as part of emergency or post-operative care; it is not a private, bookable service, though private hospitals with critical care can provide it.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Why does my relative need a ventilator, and what are you hoping it will achieve?
• Is my relative comfortable and free of distress?
• How is weaning going, and what is it waiting on?
• Might a tracheostomy be needed, and what would that involve?
• What can we expect for breathing recovery after the tube comes out?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for breathing machine (ventilator)

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: ICUsteps — Intensive care: a guide for patients and relatives ICUsteps — Weaning from the ventilator and tracheostomy information Faculty of Intensive Care Medicine — Guidelines for the Provision of Intensive Care Services (GPICS) NICE CG83 — Rehabilitation after critical illness in adults

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.