What Is Life Support and When Is It Needed?

The purpose of life support is to assist the body’s organs when they are not performing their duty well enough to maintain life. People on life support are in critical condition and monitored closely while on different equipment.

Key takeaways:
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    Being on life support doesn’t mean the person is dead, but it allows them to heal while the body rests.
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    Different types of life support can be performed in critical care and at home.
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    The option to withdraw life support is always there if you or your family decide to stop.

What does it mean to be on life support?

Life support supports one’s life with medical procedures and actions to keep someone alive until their body can support itself again. Healthcare providers use life support in the intensive care unit (ICU), sometimes known as critical care.

When a person goes on life support, they will likely be sedated to help them sleep through the process. While not all life-supportive measures require sedation, some do, as they can be invasive.

However, it is worth noting that when a person is on life support, it doesn’t mean they are dead. On the contrary, the procedure(s) is a way to prolong life.

Some reasons someone might need life support are:

  • Heart attack
  • Lung failure
  • Kidney failure
  • Stroke
  • Heart failure

As soon as you need it and your body can no longer support itself without help, the doctor may suggest starting life support. You or your family decide to be placed on life support. Additionally, at this time, you or your family can also discuss advance directives. Your doctor will not start the process if you do not want life support.

What are the different types of life support?

When people think of life support, they often think about what is seen in movies with a ventilator and tubes in their mouths. However, Hollywood often portrays this information incorrectly. Mechanical ventilation isn’t the only type of life support. Life support mechanisms can assist the heart, lungs, and kidneys.

Types of ventilation you may see in critical care include:

Mechanical ventilation

Mechanical ventilation is a type of life support that helps the lungs function. An endotracheal tube is inserted through the mouth and into the “person’s breathing tube,” also known as the trachea. The placing of the endotracheal tube is called intubation.

A ventilator regulates the person’s airflow and breathing. The ventilator pushes oxygenated air at set pressure ranges into the lungs for inhalation and exhalation.

In life support, for example, mechanical ventilation is used for many conditions affecting breathing. It can be a direct condition with your lungs, waking up too slowly from surgery, or any condition that affects oxygen levels. Examples include a heart attack or a bad infection leading to sepsis or shock.

Extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) is a therapy supporting tissue oxygenation during heart failure. When someone is on ECMO life support, they are hooked up to a machine that drains their blood and removes carbon dioxide, then re-oxygenates the blood and pumps it back into the body.

ECMO essentially works as an artificial lung filtering out the blood. This action helps the lungs rest allowing the body to heal. ECMO is often used in severe cases of advanced heart or lung failure. Conditions to use ECMO can include cardiac shock, pulmonary embolisms, and cardiac arrest.

Continuous renal replacement therapy

Continuous renal replacement therapy (CRRT) is slow and continuous dialysis that may last days or weeks. This form of dialysis cleans the blood like the kidneys would and can add and restore electrolytes and chemicals to help heal the body.

When someone is placed on CRRT support, a large catheter is placed in the groin area into the femoral vein or the jugular vein in the neck. The blood is pumped through the CRRT machine, filtered, and pumped back into the body after cleaning it.

CRRT is typically used in cases of acute kidney failure or injury to the kidneys. Dialysis can sometimes be harsh on the body, and CRRT offers a more gentle and slow way to perform dialysis in critical patients.

Intra-aortic balloon pump

An intra-aortic balloon pump (IABP) is a life support device that helps the heart control blood flow. The IABP device has a balloon that inflates when the heart is resting between beats. This helps the heart rest by taking over some of the work and allowing it to heal after a cardiac event such as a heart attack.

IABP can also be used when the heart goes into cardiogenic shock after heart surgery, or while waiting for a transplant. The placement of an IABP is typically done in a cardiac catheterization lab. A catheter is placed through the femoral vein in the groin, where the balloon is placed in the heart.

Other life support forms can be used in critical care, other healthcare facilities, and even at home.

Some of these other life support options include:

  • Artificial feeding tubes
  • Kidney dialysis
  • External pacemaker
  • Cardiopulmonary resuscitation (CPR)

How to know when to stop life support?

When you or a loved one is on life support, no rule or protocol states for how long. Your healthcare provider will decide based on your recovery and when your body is ready. Depending on the severity of the condition causing the need for life support, a full recovery of baseline functionality may not always be possible.

Suppose the physician doesn’t think there is going to be a meaningful chance of recovery. In that case, they may speak with your family about ending life support. Stopping is a personal decision that your family may have to make based on knowing your wishes.

When life support is no longer beneficial, it is considered legally and ethically acceptable to end treatment. When treatments are withdrawn, measures are taken to ensure that passing away is comfortable for the patient and the family.

What is recovery like after being on life support?

Your doctor will take you off of life support as soon as your organs can function on their own or you or your family decide to withdraw care. After being on life support, the road to recovery depends on the extent of the condition that caused the need for life support. Even after life support is removed, you may still be critically ill and need to stay in the hospital. While on life support, many people are bed bound and may need physical therapy to regain their strength.

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