Home care, vents advance in tandem

With all the hullabaloo these days surrounding ventilators, it's a good time to look at how far the technology has come in the past 25 years, says Dr. Roy Maynard, medical director for Roseville, Minn.-based Pediatric Home Service.

Right alongside the advances in technology are advances in home care, he says.

“First and foremost, people are willing to take the kids home because we have the technology,” he said. “Children do well if they are nurtured at home.”

Out of sync

Initial infant ventilators were very simplistic, says Maynard. You set the respiratory rate on the vent, but it didn't synchronize with the baby.

“The baby couldn't trigger a breath,” he said. “You just had to hope that when a baby took a breath, the vent happened to be cycling at the same time. Imagine trying to take a breath and waiting for the vent to give you that breath.”

No pressure

Hospital-based vents run off high-pressure systems, which of course families don't have at home, says Maynard. That limited who could be sent home.

“We had really specific limitations, depending on the oxygen requirements of the child,” he said. “We wouldn't send kids home unless they were at 30% or less oxygen, because you couldn't provide enough oxygen.”

Heavy load

Families also struggled with the old tanks, which weighed more than 100 pounds. Today's vents are portable, which has made a huge difference in the lives of patients, says Maynard.

“These devices get smaller and smaller,” he said. “They have little turbines inside these little boxes to generate the flow.”

Batteries are smaller and lighter, too, and the patient can get anywhere from four to 12 hours of use, says Maynard.

Quality of life

Vents can be matched to a child's needs, and they have alarm systems in case of a problem. That gives kids the freedom to be, well, kids, says Maynard.

“We have lots of kids who are dependent upon their mechanical ventilation,” he said. “They are not out playing football, but they are watching the football games, they are going to school every day, and they are learning and out in the community.”