Major innovations in respirators have freed patients from the large, imposing machines of past that were generally found only in hospitals or other facilities, and expanded the available choices of where to live and what to do. Respirators used at home work on household current and are small, lightweight and portable. They can be used at bedside or mounted on a wheelchair. What type of ventilator a person requires depends on what is causing that need. A primary care physician, and often a pulmonologist, will likely be involved in this decision.
What to Look for
The main decision to make in buying the right respirator is whether negative or positive pressure ventilation is needed. Negative pressure ventilation works by maintaining pressure that is lower than atmospheric pressure around the chest, which causes it to expand and take in air. Sometimes known as body ventilators or chest shells, this type of respirator works by creating changes in pressure between the chest and the device, facilitating breathing. Mechanical ventilation of this type is noninvasive, requiring no surgery. Often, positive pressure ventilation can be done noninvasively as well. Nasal tubing, mouthpieces and other devices work by using pressure higher than atmospheric level to push air into the body. Some patients will need the invasive models that deliver air through a tracheotomy. Among all positive pressure ventilators, the models vary according to how much assistance the user needs and at what times. Among them are bi-level positive airway pressure ventilators, pressure support ventilators and volume ventilators. For help, the International Ventilator Users Network (www.ventusers.org) provides a wealth of information about types of respirators, including statistics about expected rate of respiration, degrees of pressure, voltage, weight and more. Consumer comments are included to help you evaluate your options.
Common Pitfalls
The type of respirator you choose will not only be driven by a decision for negative or positive pressure but also what positions the user will be in most often, or in what positions the ventilator will be most needed. Some ventilators work best in a horizontal position, while some work best for users who are seated. Those using positive pressure ventilators should consider investing in a model with an integrated humidifier to combat the dryness in the nose and throat this type of ventilation can cause. When buying a ventilator, make sure to get a backup battery, or even a generator, in case of a power outage. It's a good idea to keep a manual resuscitator on hand, and to practice safety drills to better handle an emergency.
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