Some patients need other support to help them breathe. Not all patients will require these methods.
Positive Airway Pressure Devices
With CPAP (Continuous Positive Airway Pressure), a machine gives a constant amount of air (with oxygen, if needed) to the child using a face or nose mask. The amount of air given can change based on the child’s needs and comfort.
BiPAP (BiLevel Positive Airway Pressure) is like CPAP in that a machine gives a certain amount of air (with oxygen, if needed) to the child using a face or nose mask. With BiPAP, though, the amount of air is higher when the child breathes in and lower when the child breathes out. Also, BiPAP machines can give a set breath rate, beyond the extra help given when the child breathes on his or her own.
Some kids use CPAP or BiPAP just during sleep. Some kids use CPAP or BiPAP during sleep and while awake — any time they feel like they need it.
A tracheostomy is a short breathing tube that goes from the outside of the neck, just below the vocal cords, to the inside of the trachea (or windpipe). Only a few children with chILD need a tracheostomy. Tracheostomies are often done if a child needs long-term mechanical ventilation, if the upper airway is blocked, or if handling extra lung mucus is a problem. A pediatric surgeon or an ear, nose, and throat (ENT or otolaryngology) specialist does the surgery. The hospital stay may last 2-3 weeks or more. While there, you will be taught how to manage the tracheostomy, handle emergencies, change the tracheostomy tube and ties, suction and clean the tracheostomy tube, and do CPR (though ALL parents should learn CPR).
Children with tracheostomies cannot cry aloud or talk since the tube bypasses the vocal cords. Sometimes they can use a speaking valve to make normal sounds. Children with tracheostomies need their air to be warm, moist and filtered since the tube bypasses the upper airway. Your child’s cough will not work as well with a tracheostomy tube, so you will suction the tube to remove lung mucus. If your child needs a tracheostomy, the DME vendor will give you tracheostomy supplies; a warm, moist, filtered air source; and a suction machine and supplies.
When kids with chILD need extra help breathing, even beyond what CPAP or BiPAP can give, a ventilator may help. As with tracheostomies, very few kids with chILD need this kind of help at home. Ventilators are machines that can give either a little extra breathing help or do all of the breathing for you.
The machine gives this breathing help using either a face or nose mask or tracheostomy tube. Of course, the more support a machine gives, the harder it is to learn how to use it. Your health care team and DME vendor will teach you how to use the ventilator and its supplies.
