CPAP ventilation

What is CPAP ventilation?

Continuous positive airway pressure (CPAP) is a type of respiratory support therapy used to overcome obstruction of the airways. The air is given to your child through a mask attached to an electrically powered machine called a CPAP driver. The mask (either nasal, face or prongs into the nostrils) is held in place by a little cap (headgear) or straps.

Why does my child need CPAP ventilation?

This depends on the child. Many parents are not sure if their child will cope with the mask, but we find that most children tolerate CPAP as they find it gives them relief from their symptoms. Most children adjust very quickly and will wear the mask all night long, while others may take a few days, weeks or months.

How long does CPAP need to be used?

For the best benefit, CPAP should be used all night, every night. However, we know it may take some time before your child can manage this. If they won’t wear it all night keep encouraging your child to use the CPAP for as much of the night as possible.

Will my child ever be able to stop using the treatment?

CPAP controls obstructive sleep apnoea but does not cure it. The decision for your child to continue or stop using the CPAP is very individual and may relate to what caused the problem and whether any other treatment is available. Please discuss this with your child’s doctor.

Who is involved in my child’s care?

• an ‘in hours’ telephone service to deal with any issues you may have
• a community nurse able to provide support and help in your own home
• regular oximetry tests carried out at home
• an annual overnight stay in hospital to have more detailed monitoring and equipment check
• regular clinic appointments with your consultant to monitor your child’s respiratory function

Beginning ventilation

At the moment we are trying to start the CPAP at home rather than in a hospital setting. We believe that this is less stressful for you and your child, and helps with their compliance. However, this is dependent on the severity of your child’s condition and is ultimately at the discretion of your consultant.

It is important for your child that ventilation starts happening as soon as possible. If this cannot be done at home then we will need to arrange a hospital admission to help with the getting going. 

Where do I get a CPAP machine and supplies?

Initially the hospital will provide you with a ‘loan’ machine to borrow. This will be arranged by the hospital and your local Primary Care Trust (now known as Clinical Commissioning Groups (CCG)) to provide your child with a suitable CPAP machine as required. Once treatment levels are established, your local CCG will buy a ventilator for your child. The management and servicing of this ventilator will be supervised by Sheffield Children’s hospital.

Once we have agreed to start your child’s treatment we will provide you with the following:

• a ventilator
• 2 nasal masks
• spare ventilator tubing
• spare dust filters for your machine
• humidifier (if needed)

How do I look after the CPAP ventilation equipment?

CPAP machine

The CPAP machine will just need wiping clean with a damp cloth. All settings and buttons on machine are locked, so you cannot accidently change any settings whilst cleaning machine. If your machine has a humidifier chamber, this can be washed out with hot water and left to dry.

⚠ Do not put humidifier chambers through dishwashers as this can damage them.

Mask, headgear and tubing

Disconnect and air out the mask and tubing every day. Wash them out once a week by hand washing them in warm soapy water. Make sure all the parts are thoroughly rinsed and given time to air dry before using on your child again. This will reduce the risk of infection, pressure sores and will look after the equipment. If the mask is contaminated with bodily fluids at any point, please clean using the above method. The cloth headgear cannot be washed and spares will be given if they become dirty.

Air filter

There are 2 air filters on your machine. The round, bacterial air filter (at the front of the machine) should be changed at least once per month. The internal dust filter will be changed by your community nurse. Do not wash or reuse old air filters.

Humidifier

If using a humidifier, empty the water from the chamber every day and replace with fresh distilled or cooled boiled water. Pour the fresh water up to the specified line before use each night. If you have limescale build-up in the humidifier chamber, soak the chamber in a solution of 1 part vinegar to 10 parts water. After 10 minutes, rinse thoroughly and leave to dry.

Are there any problems associated with CPAP use?

If your child’s mask is too tight on their face it can sometimes cause pressure on their face. This can cause discomfort and can occasionally make the face sore. Making sure that the mask fits well and not too tight will help this. If your child’s face does become sore, please contact the team for advice.

What if the CPAP machine or supplies break or malfunction?

Most children will not suffer from one night without CPAP therapy. However if there is a problem with the machine please contact us as soon as possible so we can correct the fault and give you with a replacement machine.

If a problem occurs within office hours please contact either Lee Richardson or Amika Challacombe on either the mobile or office telephone.

If a problem occurs out of office hours and you are concerned about your child’s welfare, you may need to contact Sheffield Children’s to get advice from the medical registrar on-call. They can be contacted via switchboard on 0114 271 7000.

There is also a dedicated webpage providing troubleshooting guides, patient information resources and further contact information.

Follow up appointments

When you come for a follow up appointment, please bring all of your child’s equipment with you. This includes the ventilator, mask and tubing so that we can check and service them.

Your child will receive regular home visits from the specialist nurse to check on your progress and carry out home monitoring.

You will also have regular clinic appointments with their consultant in the hospital, and once a year have an overnight stay in hospital to make sure that all the settings on the machine are correct for your child’s needs.

⚠ It is very important your child attends their clinic appointment so the medical team can keep a regular check on your child’s progress.