It has long been recognized that pressure breathing, both positive and negative, influences the production of the antidiuretic hormone, causing an excess of this hormone and a resultant retention of water. If not corrected, the situation can lead to pulmonary edema and further interference with the patient's ventilation. The possibility of such an eventuality demands that accurate records be kept of the patient's intake and output and that a safe balance be maintained. A thorough knowledge of the apparatus being used for mechanical ventilation is vital to competent care of the patient. No one should attempt to give patient care without prior instruction in the purpose of the machine and the physiologic and physical principles upon which it operates.
Suction is applied as necessary and some method for moisturizing the air is provided.
In fact, whether the patient has a tracheostomy or not, the air passages must be kept moist whenever a ventilator is used for a prolonged period. When such symptoms appear the rate of nebulization requires adjustment. The psychologic implications of the use of a ventilator are manifold. When a ventilator is used for a brief period as a means of therapy, patients can be told that they can control the cycle by the slightest effort on their part. Once they understand the way the machine works and their questions are answered to their satisfaction their fears can be allayed.