Home Mechanical Ventilation Program

Mechanical ventilation helps children with certain conditions breathe and get enough oxygen. The pediatric Home Mechanical Ventilation Program at Children’s Hospital Los Angeles is one of the largest and most experienced in the world. We provide advanced breathing support for hundreds of children every year.

Home Mechanical Ventilation Care: Why Choose Us?

Dedicated home mechanical ventilation services are a specialized pulmonology offering at CHLA. U.S. News & World Report ranks our pediatric pulmonology and sleep medicine services among the country’s best.

Our Home Mechanical Ventilation Program offers:

  • Deep expertise: As one of the country’s first dedicated mechanical ventilation programs for children, we have decades of experience providing lifesaving breathing support for even the smallest patients. We’ve successfully helped hundreds of infants, children and teens who need full- or part-time at-home mechanical-assisted ventilation. Our pulmonology services also include care for children who use diaphragm pacing and positive airway pressure (PAP).
  • Collaborative care for all conditions: Many conditions can affect a child’s ability to breathe. Our program brings together specialists from different medical fields to manage all your child’s health care needs. Meet our team.
  • Dedicated experts: Our team of experts provide in-depth training and support, ensuring you feel confident caring for your child at home. A team member is available 24/7 to answer questions.
  • Support for the whole family: We partner with your family to ensure your child thrives at home, school and life. We also help you manage the stress of caring for a child with potentially life-threatening needs. Your family benefits from mental health support, financial assistance and more.
  • Evidence-based care: Our team is active in research and clinical trials to improve the prognosis and care of children who need mechanical ventilation and breathing support.

What Is Home Mechanical Ventilation?

Mechanical ventilation supports your child’s lungs and breathing. A ventilator system (also called a respirator or breathing machine) sends air directly into your child’s airways and lungs. Air travels from the ventilator to a tube that goes into a surgically created hole (tracheostomy) in your child’s windpipe. Some children get air through a face mask or nasal cannula (flexible tube in the nose) and don’t need a tracheostomy.

Mechanical ventilation:

  • Provides the right amount of oxygen for your child, as determined and adjusted by your child’s pulmonologist (lung specialist)
  • Removes carbon monoxide gas from the lungs
  • Delivers pressurized air that prevents tiny air sacs in the lungs (alveoli) from collapsing

Your child may need mechanical ventilation support all day or only at night when they sleep. Our team will discuss your child’s options with you.

Other types of breathing support

We also provide expert care for children who use other types of breathing support, either along with or instead of mechanical ventilation. These include:

Diaphragm pacing

Diaphragm pacing helps children born with a rare genetic condition called congenital central hypoventilation syndrome (CCHS). A portable pacemaker device sends electrical impulses to tiny transmitters (electrodes) surgically attached to nerves that control breathing.

Children with CCHS need 24/7 breathing support. Some children who get diaphragm pacing only need mechanical breathing support when they sleep. Learn more about our CCHS and Diaphragm Pacing Program.

Positive airway pressure (PAP)

Positive airway pressure (PAP) is a type of noninvasive mechanical ventilation. Your child breathes through a face mask that connects via a tube to a PAP machine. The device delivers air at a controlled pressure that keeps the airways open while your child sleeps.

Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BiPAP) support nighttime breathing in children who have sleep-related breathing disorders, such as sleep apnea. This condition causes short pauses in breathing. Some children with CCHS who use diaphragm pacing may be able to use PAP at night instead of a home ventilator.

Our nationally accredited pediatric Sleep Center has a dedicated PAP Clinic for children using this form of breathing support.

Who needs breathing support?

Children at risk for respiratory failure need breathing support. A child with respiratory failure can’t maintain healthy oxygen or carbon dioxide levels. Many conditions can cause respiratory failure, including:

  • Congenital central hypoventilation syndrome (CCHS)
  • Down syndrome
  • Early (premature) birth
  • Heart conditions, including heart failure
  • Infant chronic lung disease (bronchopulmonary dysplasia) and other lung diseases
  • Paralysis
  • Sleep-related breathing disorders, such as sleep apnea
  • Spinal muscular atrophy and other neuromuscular disorders

Home Mechanical Ventilation Program: What to Expect

Advancements in mechanical ventilation systems make it possible for your child to leave the hospital and receive at-home breathing support so they can fully participate in family activities. Your child must be medically stable with no changes to their treatment for one to two weeks before they can go home on a ventilator.

We understand that caring for a child on a ventilator may seem daunting. A team of experts at our Home Mechanical Ventilation Program provide comprehensive education and training. We make sure you have the knowledge, support and training to confidently care for your child at home.

In-hospital training

Before your child can leave the hospital and make the transition to home ventilation, two caregivers must successfully complete our in-hospital training. This training ensures you know how to care for your child, understand how to use the ventilator and can respond appropriately to emergencies.

Our team provides hands-on instruction using mannequins and other teaching tools. During in-hospital training, two caregivers:

  • Receive six hours of training per day, four days a week for four weeks
  • Complete a 24-hour session at the end of training, providing all aspects of your child’s care with supervision but without needing assistance

Caring for your child at home

We work closely with medical equipment companies and home health care providers to ensure you have the supplies and resources you need to care for your child at home. An expert from our team is available 24/7 to answer questions and provide support.

When you get home, you can expect these steps:

  • Within 48 hours of discharge, you will have a virtual telehealth visit with your child’s pulmonologist and nurse care manager.
  • Two weeks after discharge, you come back to CHLA for an in-person visit.
  • You continue to have in-person or virtual visits every six to eight weeks for the first six to 12 months.
  • Follow-up in-person or virtual visits then happen once every three months.

Multidisciplinary Home Mechanical Ventilation Care Team

Your child receives coordinated care from a team of medical experts. In addition to pulmonologists and respiratory care practitioners, your child’s care team may include:

Other care team members may include:

Pulmonology and Sleep Medicine Care at Children's Hospital Los Angeles

Our expert team of pulmonology and sleep medicine specialists diagnoses and manages all types of breathing, lung and sleep issues in children. Learn more about our leading-edge Pulmonology and Sleep Medicine services.

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Pulmonology and sleep medicine experts at CHLA welcome new patients, referrals and second opinions. Please contact us:

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