A respiratory therapist (RT) is a health professional specially trained to help patients with respiratory (breathing) disorders. Respiratory therapists provide breathing and oxygen support to patients who have trouble getting enough oxygen into their blood, either because of an existing heart condition that makes it difficult for the heart to pump efficiently or after surgery to treat a heart condition.
If your child has just had heart surgery, they will see an RT immediately after the procedure for help resuming breathing. This is necessary because the sedation or anaesthesia temporarily suppresses the child's natural breathing ability. Your child might also see an RT if their breathing and oxygen intake needs support prior to surgery. This is more common in children awaiting heart transplants or those who have conditions like dilated cardiomyopathy. Sometimes children need respiratory support during surgery or cardiac catheterization.
How will the respiratory therapist help your child?
The respiratory therapist will carefully assess your child's needs and make use of the most appropriate breathing treatment in order to help them. The most commonly used treatment is mechanical ventilation, which is a machine that helps patients breathe after surgery. Another approach is extracorporeal life support (ECLS). This was formerly called extracorporeal membrane oxygenation. Some RTs have special training in ECLS. This machine is used in patients whose hearts need more aggressive support after being on cardiopulmonary bypass or in patients who need support prior to surgery.
RTs also work with your child to find the best positioning in bed, in terms of comfort and ease of breathing. They also interpret chest X-rays and sometimes do electrocardiograms. In addition, RTs are involved in arranging for home oxygen if children need support at home, and in teaching parents how to give their children oxygen.
How does the RT monitor the impact of breathing treatments?
The RT will continually evaluate cardiorespiratory function, listen to your child's chest, check vital signs, and watch for improvement or deterioration. The RT does blood work to see how much oxygen and carbon dioxide there is in the blood — called dissolved oxygen and saturation — as well as pH levels, which indicates the acidity or alkalinity of the blood. The chemistry of the blood and the numbers of red and white blood cells are also monitored. This is achieved by drawing blood and having it analyzed. Based on the ongoing assessment, the respiratory therapist will adjust the ventilator settings as needed.
