Lungs are the primary organ involved in gas exchange where it allows the oxygen to enter blood and removed the unwanted carbon dioxide from the blood. When we breathe in air the respiratory muscles enable the air to pass into the lungs, the airways push the air further deep into the lungs where the actual gas exchange takes place. In certain diseases, when the body is not able to maintain a normal oxygen and carbon dioxide level, respiratory failure occurs and child requires mechanical ventilation at home.

In which condition Home Ventilation is required?

There are certain medical problems that can lead to respiratory failure and require a child to use a ventilator for long period of time. For example:

• Chronic diseases that affect the lungs (extremely premature birth, interstitial lung diseases, severe infections),
• Disease of the muscles and bones that may lead to insufficient breathing effort,
• Disease of the nervous system that lead to poor breathing effort or weakness,
• Narrowing or collapsed airways that limit airflow and breathing.

What does the Ventilator do?

The ventilator helps the child breathe better. It does this in several ways:

• The ventilator supplies extra oxygen to the lungs and aids in removing carbon dioxide.
• It blows air into the lung at a pre-determined pressure to keep the collapsed airways open and ensures air supply to all parts of the lungs.
• It reduces the work of breathing by supporting the respiratory muscles and allows time for the lungs to heal.

What equipment will we need at home?

All children must have the following equipment:

• a ventilator (CPAP, or  BiPAP)
• ventilator back up (fully charged) batteries
• a humidifier for the ventilator
• oxygen supply
• a self-inflating resuscitation bag and mask (Ambu bag)
• a suction machine (stationery and portable)
• A pulse oximeter

An emergency bag including items such as a extra tracheostomy tube, self-inflating resuscitation bag, torch, and suction catheters should be kept ready.

How will I manage home ventilation, I am not a doctor?

A pediatric pulmonologist guides the parents of children who require home ventilation regarding all the aspects of the ventilator. A demonstration of the ventilator machine is given to the parents and settings are adjusted as per the child’s lung requirements. Red flag signs and things to monitor are explained to the parents before discharging the child form the hospital by the doctor.