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Tuesday, September 30, 2014
Ventilator and pulmonary fibrosis
My father, age 74, had a 2 way bypass and a heart valve replacement surgery 6 weeks ago. He is still in the ICU unit in the hospital because since the surgery he has suffered pneumonia, a stroke, HITT (reaction with heparin), and had a tracheotomy to help clean his lungs and remove the fluid build up in his lungs. He had a lung biopsy last week and the diagnosis is Pulmonary Fibrosis. We just found out yesterday. He is on a ventilator 24 hours a day through his tracheotomy and it is working at 40% (he is breathing at 60% on his own). He has 96% to 100% oxygen in his lungs with the help of the ventilator.
My question is... how does someone die with pulmonary fibrosis if they are on a ventilator to help them breathe? Would he be taken off he ventilator - like `pulling the plug`?
Thank you for your advise.
Given the multiple medical problems that he has, it is not clear whether the pulmonary fibrosis is the main barrier to coming off of the ventilator or if there are other reasons that he is not coming off.
In complex situations such as this, it is best to schedule a meeting with the pulmonologist involved in his care so that you can determine what aspects of his respiratory failure are reversible and what aspects are not reversible.
Any decision about taking him off of the ventilator would be based on his stated preferences or the preferences of his next of kin if he is not able to express his wishes.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University