A former children's hospital respiratory therapist was sentenced Wednesday to 45 years and 8 months in prison for molesting five disabled children and taking pornographic photographs of others in a crime several of the victims' families described as their worst nightmares.

"I just want you to know it doesn't matter what you say or how many years you spend in jail — it's not going to be enough," parent Lillian Godfrey told Wayne Albert Bleyle at his sentencing hearing. "I don't think you have a soul. You're just an empty human shell."

Bleyle, who told investigators he molested as many as half the children he treated in his 10 years working in the convalescent ward at Rady Children's Hospital, did not turn to look as a succession of weeping parents and family members spoke from the public gallery just behind him. Instead, he stared straight ahead or cast his eyes down at the table in front of him.

"The acts Mr. Bleyle inflicted on my daughter ... disabled, mentally fragile, are a parents' worst nightmare," said Janice Frost, whose 10-year-old daughter died in June 2006, three months after federal investigators discovered her image in pornographic photos on Bleyle's home computer. "I was unable to protect her as a mother from a man like you."

Prosecutors said Bleyle, 56, targeted patients who were comatose, brain-damaged or too disabled to speak. He was arrested in March 2006 after investigators tracing pornography through the Internet found tens of thousands of pornographic images on his computer, including photographs he took of himself abusing his patients.

Under an agreement reached in June, Bleyle pleaded guilty to eight counts of forcible lewd acts involving five children, although investigators were never able to put a name to one of the victims, a 2-year-old girl found in pictures.

At a hearing in June, he also agreed to plead guilty to four counts of exhibiting minors in pornographic materials, a dramatic reduction from the total 33 pornography counts originally charged.

The plea was modified Wednesday, with prosecutors dropping one pornography count and Bleyle pleading guilty to a single count of posing a child for pornographic purposes.

He was dressed in prison blues and did not address the court except to murmur, "Guilty, your honor" when asked how he pleaded to the posing charge.

His attorney, Casey Donovan, spoke on his behalf after the families were finished.

"He wishes to apologize to all the victims and their families," said Donovan, who noted that Bleyle himself had been sexually abused as a boy. "He knows he can never make amends for what he has done."

Bleyle was ordered by Superior Court Judge Kenneth K. So to serve at least 85 percent of the time in prison, even with credit for good behavior. He faced up to 165 years if he had been convicted on all counts in a jury trial.

"You have violated the trust of your patients, you have violated the trust of your employer, and you have inflicted indescribable anguish on your victims and their families," So told Bleyle.

Bleyle was also ordered to pay restitution — to be determined at a later date — to the families of the victims.

Prosecutors said they made a deal in part because they were anxious to spare one of Bleyle's victims, a teenage girl who claimed Bleyle inappropriately touched her buttocks while she recovered from a stroke, the strain of testifying before a jury.

"This provides closure for everybody," Gunn said outside the courtroom.

Investigators identified just four of Bleyle's victims: three girls and a boy who were all younger than 14 when the molestations took place. Two of the children have since died.

Bleyle worked at the well-regarded children's hospital in San Diego for 25 years. He was identified by federal agents who traced child porn through Internet file-sharing networks to his home computer in suburban Santee. He confessed to investigators who reached him by phone in New York state, where he was visiting relatives, that he had molested as many of his patients as there were snowflakes falling outside his window, according to Immigration and Customs Enforcement agents.

A month after Bleyle's arrest, a second hospital employee, tracked through peer-to-peer networks, was charged with molesting a comatose toddler patient.

Christopher Alan Irvin, a 32-year-old nurse at the time, pleaded guilty in September to molesting the toddler and was later sentenced to 14 years and eight months in prison.