The term “life support” refers to any combination of machines and medication that keeps a person’s body alive when their organs would otherwise stop working.
Usually people use the words life support to refer to a mechanical ventilation machine that helps you breathe even if you’re too injured or sick for your lungs to keep working.
Another cause for the need of a ventilator is a brain injury that doesn’t allow the person to protect their airway or initiate breaths effectively.
Life support is what gives doctors the ability to perform complicated surgeries. It can also prolong life for people who are recovering from traumatic injuries. Life support can also become a permanent necessity for some people to stay alive.
There are many people who have portable ventilators and continue to live a relatively normal life. However, people who are using a life-support device don’t always recover. They may not regain the ability to breathe and function on their own.
If a person on a ventilator is in a long-term state of unconsciousness, this can put family members in the difficult situation of choosing whether their loved one should continue to live in an unconscious state with the help of the machine.
The respirator takes on the job of providing breaths and assisting with gas exchange while the rest of your body gets a break and can work on healing.
Respirators are also used in the later stages of chronic health conditions, such as Lou Gehrig’s disease or spinal cord injuries.
Most people who need to use a respirator get better and can live without one. In some cases, the life support becomes a permanent necessity to keep the person alive.
Cardiopulmonary resuscitation (CPR)
CPR is a basic first aid measure to save a person’s life when they stop breathing. Cardiac arrest, drowning, and suffocation are all instances in which someone who’s stopped breathing may be rescued with CPR.
If you need CPR, the person giving CPR presses down on your chest to keep your blood pumping through your heart while you’re unconscious. After successful CPR, a doctor or first responder will assess if other kinds of life-support measures or treatment are needed.
A defibrillator can get your heart to beat normally despite an underlying health condition that could lead to greater complications.
Also known as “tube feeding,” artificial nutrition replaces the act of eating and drinking with a tube that directly inserts nutrition into your body.
This isn’t necessarily life support, as there are people with digestive or feeding issues who are otherwise healthy who may rely on artificial nutrition.
However, artificial nutrition is typically part of a life-support system when an individual is unconscious or otherwise unable to live without the support of a respirator.
Artificial nutrition can help maintain life at the end stages of some terminal conditions as well.
Left ventricular assist device (LVAD)
An LVAD is used in cases of heart failure. It’s a mechanical device that assists the left ventricle in pumping blood to the body.
Sometimes an LVAD becomes necessary when a person is awaiting a heart transplant. It doesn’t replace the heart. It just helps the heart pump.
LVADs can have significant side effects, so a person on the heart transplant list might opt against having one implanted after evaluating their likely wait time and risk with their doctor.
Extracorporeal membrane oxygenation (ECMO)
ECMO is also called extracorporeal life support (ECLS). This is due to the machine’s ability to do the job of either just the lungs (veno-venous ECMO) or both the heart and the lungs (veno-arterial ECMO).
It’s especially used in infants who have underdeveloped cardiovascular or respiratory systems due to serious disorders. Children and adults can also need ECMO.
ECMO is often a treatment used after other methods have failed, but it can certainly be quite effective. As a person’s own heart and lungs strengthen, the machine can be turned down to allow the person’s body to take over.
In some cases, ECMO may be used earlier in treatment to prevent damage to the lungs from high ventilator settings.
Doctors start life support when it’s clear your body needs help to support your basic survival. This could be because of:
- organ failure
- blood loss
- an infection that’s become septic
If you’ve left written instructions that you don’t want to be put on life support, the doctor won’t start the process. There are two common types of instructions:
- do not resuscitate (DNR)
- allow natural death (AND)
With a DNR, you won’t be revived or given a breathing tube in the event that you stop breathing or experience cardiac arrest.
With AND, the doctor will let nature take its course even if you need medical intervention to stay alive. Every effort will be made to keep you comfortable and pain-free, however.
With life support technology, we have the ability to keep people alive much longer than we used to. But there are cases where difficult decisions about life support may rest with a person’s loved ones.
Once the brain activity of a person stops, there’s no chance of recovery. In cases where there’s no brain activity detected, a doctor may recommend turning off a respirator machine and stopping artificial nutrition.
The doctor will conduct several tests to be completely certain there’s no chance of recovery before making this recommendation.
After turning off life support, a person who’s brain-dead will die within minutes, because they won’t be able to breathe on their own.
If a person is in a permanent vegetative state but not brain-dead, their life support likely consists of fluids and nutrition. If these are stopped, it may take anywhere from a few hours to several days for the person’s vital organs to shut down completely.
When you consider whether to turn off life support, there are many individual factors at play. You may wish to think about what the person would have wanted. This is called substituted judgment.
Another option is to consider what’s in the best interest of your loved one and try to make a decision based on that.
No matter what, these decisions are intensely personal. They’ll also vary according to the medical condition of the person in question.
There really are no reliable metrics for the percentage of people who live after life support is administered or withdrawn.
The underlying causes of why people go on life support and the age they are when life support is needed makes it impossible to statistically calculate outcomes.
But we do know that certain underlying conditions have good long-term outcomes even after a person has been put on life support.
Statistics suggest that people who need CPR after a cardiac arrest can make a full recovery. This is especially true if the CPR they receive is given properly and immediately.
After time spent on a mechanical ventilator, life expectancy predictions become harder to understand. When you’re on a mechanical respirator as part of an end-of-life situation for a long period of time, your chances of surviving without it begin to decrease.
No one wants to feel like “it’s all up to them” as they make a decision about life support for a loved one. It’s one of the most difficult and emotional situations that you may find yourself in.
Remember that it’s not the decision to remove life support that will cause your loved one to pass away; it’s the underlying health condition. That condition isn’t caused by you or your decision.
Talking to other family members, a hospital chaplain, or a therapist is critical in times of grief and stressful decision-making. Don’t be pressured to make a decision about life support you or the person you’re making it for wouldn’t be comfortable with.