Pediatric Home Ventilator Program
The Pediatric Home Ventilator Program at BLK Hospital is dedicated to supporting the care of children with diseases that require long term assisted home mechanical ventilation.
Home ventialtion Types:
Non Invasive Ventialtion: Here the ventilator is connected to a tubing/mask. The mask is applied on the child’s nose (nasal mask) or sometimes nose and mouth (oro-nasal mask). This form of mask ventilation requiring support only at night is commonly called as Non Invasive ventilation or NIV. This is the most common form of home ventailation.
Invasive ventilation: Occasionally a child might need to be on ventilation with a tracheostomy tube. This type of ventilation is usually given throught the day. This is a form of Invasive Ventilation.
There are three groups of children who require long term support:
Neuromuscular Disorders: Children with congenital myopathies, muscular dystrophies (Duchenne’s Muscular Dystrophy etc) or spinomuscular atrophy might develop weakness of their respiratory muscles. This weakness is first during sleep. This usually happens around the time when children become non-ambulatory (not able to walk). This weakness of the chest muscles can be diagnosed by doing a sleep study. Some of these children later might need support for maintaining there lungs in a good shape during night. These children usually need a BiPAP (Bilevel Positive Airway Pressure) with a nasal or a oro-nasal mask.
Tracheostomy dependant children: Some children are on tracheostomy due to various reasons like spinal cord diseases, trauma, poliomyelitis, gullian barre syndrome etc. These children might in addition need home ventilation with tracheostomy.
Obstructive Sleep Apnea Syndrome (OSAS): Require support during breathing with usually a CPAP machine (Continuous Positive Airway Pressure). Some children with OSAS require BiPAP (Bilevel Positive Airway Pressure) if not doing well on a CPAP.
Our team works with the child and family, from diagnosing sleep related breathing problems, discussing the need and benefit of long term ventialtion, choosing the most appropriate mask, helping the child to acclamitize to the system, choosing the best ventilator, troubleshooting equipment, managing infections etc. The aim is to achieve optimal growth and development, reduces hospital admissions to minimum and have the best possible quality of life.
The usual steps for a sucesssul NIV in children are shown in the figure below.