Pediatric Ventilator Dependency

A ventilator is a machine that pumps air into your child’s lungs. This air can contain extra oxygen if needed. The movement of air into and out of the lungs will also help remove carbon dioxide, which is the waste product of ventilation. A ventilator provides a steady, reliable supply of oxygen to your child.

Some children will need a ventilator to breathe as soon as they are born because they are born prematurely or have a heart or lung condition. Other children may need a ventilator due to neuromuscular conditions, like muscular dystrophy, that leave them too weak to take an adequate breath.

Many children are vent dependent temporarily. Their lungs will grow stronger, and they can stop using the ventilator. Some children will need a ventilator for their entire lives because their medical condition prevents them from getting stronger.

Children may be connected to a ventilator in one of two ways.

Intubation

Intubation means that doctors place a tube connected to a ventilator down your child’s throat, directly into their lungs. Children who are intubated cannot eat through their mouths, speak or leave their beds. They are typically sedated to help them stay comfortable. Children who are intubated receive care in the ICU.

Tracheostomy

A tracheostomy is a hole in the front of your child’s neck where a tube can be placed into their trachea. The tube is connected to a ventilator. Children with tracheostomies can speak, eat and move around.

Children who need a ventilator will show signs of respiratory distress such as:

• Accessory muscle use (when you can see between your child’s ribs or the muscles in their neck when they breathe)
• Bluish lips or nails
• Fast breathing
• Fatigue
• Flared nostrils
• Increased heart rate
• Sweating
• Wheezing or grunting noises

If your child shows any of these symptoms, seek medical attention right away.

Many different medical conditions can cause vent dependency, including:

• Premature birth
• Neuromuscular conditions like muscular dystrophy
• Heart or lung conditions your child is born with (known as a congenital condition)
• Craniofacial abnormalities
• Lung diseases that get worse over time

When children first develop ventilator dependency, they will need to stay in either the intensive care unit (ICU) or neonatal intensive care unit (NICU). Your child will likely be intubated during this time.

If your child will be on a ventilator for many months, their doctor will likely recommend a tracheostomy. Tracheostomies give your child more freedom to move, speak, eat and experience the world while they rely on a ventilator to breathe.

To place a tracheostomy, your child’s doctor will perform a short surgery. They will make an incision in the front of your child’s neck so that they can place a tube through the skin and into the trachea.

After tracheostomy recovery, your child can begin to move more around the hospital. They will leave the ICU and spend time in Our Children’s House. At this specialized rehabilitation hospital, your child can receive physical therapy, respiratory therapy, occupational therapy, speech therapy and nutrition counseling every day, helping them make progress toward going home. They can play in playrooms, socialize with other kids and even go outside with their ventilator.

The Pulmonology Therapy program at Our Children’s House can help you learn what you need to know to care for your child at home. Parents receive training on how to bathe, feed and dress children who have tracheostomies. Our compassionate team will also teach you things like how to care for your child’s equipment, transport them from place to place.

Some children may be able to grow stronger and eventually stop using their ventilator. Your care team can help you and your child understand what to expect as they grow.