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Respiratory and Sleep Medicine


Technology Dependent Center

The Children's Hospital at Montefiore has established the Technology Dependent Center (TDC) to improve the care of children who require any type of technology to assist with breathing. This includes: supplemental oxygen and airway clearance devices, non-invasive ventilation (CPAP or BiPAP), artificial airway (tracheostomy), and mechanical ventilation. The center functions as a multidisciplinary team, with physicians from the Division of Pulmonary Medicine and from the Department of Pediatric ENT, as well as a respiratory therapist, nurse practitioner, social worker and speech pathologist - all working together to provide state-of-the-art inpatient and outpatient care for the child with special ventilatory needs. Our philosophy is that even kids with complex medical care should be cared for at home, where they can have a normal healthy wholesome environment for growth and development, as well as decreased need for frequent hospital care.

State-of-the-Art Technology

technology department center The Technology Dependent Center provides ongoing assessment and treatment of conditions such as chronic respiratory failure and insufficiency in patients with neuromuscular disease, bronchopulmonary dysplasia and upper airway obstruction. Once the medical decision is made for the use of non-invasive ventilation at home or for placement of artificial airway (tracheostomy), our team will meet you and start the educational process. We will talk about the diagnosis and the impact of the technology use on the family and your child's life. Esther Matta, RRT and Anne Haber, NP will meet with the care givers for teaching sessions and the social worker will provide social and technical resources for an easy transition to the home environment. Additionally, the physician will provide a daily medical evaluation.

Once at home, your child will be seen frequently, depending on his/her age and disease severity. The outpatient evaluation includes a comprehensive history and physical examination, assessment of growth, measurements of oxygenation and ventilation, and when possible, other measurements of lung function. These visits are multi-disciplinary in that they involve the attending pulmonary physician, a the respiratory therapist, nurse practitioner and social worker, all specialized in the care of children requiring extra technology to breathe. We will evaluate your child together with the speech pathologist and Pediatric ENT to assess the airway and promote speech development. We will communicate and coordinate care between the primary pediatrician, the different subspecialists caring for your child and the home care company and nursing company involved in your child's care.

While patients are cared for at home by parents and/or nurses, our staff remains available for telephone consultations. The pulmonary team is available 24 hours a day, 7 days a week to answer your questions and address medical and technical issues.