Intubation: What Is Intubation and Why Is It Done?

What Happens During Intubation For Surgery

Mature female patient on respiratory ventilator in intensive care unit
David Joel/Photographer's Choice RF/Getty Images

Intubation Explained

Intubation is the process of inserting a tube, called an endotracheal tube (ET), through the mouth and then into the airway. This is done so that a patient can be placed on a ventilator to assist with breathing. The tube is then connected to a ventilator, which pushes air into the lungs to deliver a breath to the patient. 

This process is done because the patient cannot maintain their airway, cannot breathe on their own without assistance or both.

 This may because they are being given anesthesia and will be unable to breathe on their own during surgery, or they may be too sick or injured to provide enough oxygen to the body without assistance.  

Nasal Intubation

In some cases, if the mouth or throat is being operated upon or has been injured, the breathing tube is threaded through the nose instead of the mouth, which is called a nasal intubation.  The nasotracheal tube (NT) goes into the nose, down the back of the throat and into the upper airway.  This is done to keep the mouth empty and allow the surgery to be performed.  

This type of intubation is less common, as it is typically easier to intubate using the larger mouth opening, and because it just isn't necessary for most procedures.  

When Intubation Is Necessary

Intubation is required when general anesthesia is given. The anesthesia drugs paralyze the muscles of the body, including the diaphragm, which makes it impossible to take a breath without a ventilator.

Most patients are extubated, meaning the breathing tube is removed, immediately after surgery.  If they patient is very ill, or having difficulty breathing on their own, they may remain on the ventilator a longer period of time.  After most procedures, a medication is given to reverse the effects of anesthesia, which allows the patient to wake quickly and begin breathing on their own.

 For some procedures, such as open heart procedures, the patient isn't given the medication to reverse anesthesia, and will wake slowly on their own.  These patients will need to remain on the ventilator until they are awake enough to protect their airway and take breaths on their own. 

Intubation is also performed for respiratory failure.  There are many reasons why a patient may be too ill to breathe well enough on their own.  They may have an injury to the lungs, they might have severe pneumonia or a breathing problem such as COPD. 

If a patient cannot take in enough oxygen on their own, a ventilator may be necessary until they are once again strong enough to breathe without assistance.

Do Not Intubate 

Some patients make their wishes known using an advanced directive, a document that clearly indicates their wishes for their healthcare.  Some patients choose the "do not intubate" option, which means that they do not want to be placed on a ventilator to prolong their life.  The patient is in control of this choice, so the may choose to temporarily change this choice so that they may have surgery that requires a ventilator, but this is a binding legal document that cannot be changed by others under normal circumstances.

 

More Information: All About Anesthesia

Pronunciation: in-too-bay-shun

Also Known As: ET tube, breathing tube, ventilation, intubated, intubate,

Common Misspellings: entubation, inntubation, intoobation, intobation, entobation, intubasion,

Examples: The intubation was performed and then the surgery began.

Continue Reading