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Outpatient respiratory management of the child with severe neurological impairment
  1. Nadine McCrea1,
  2. Roddy O'Donnell2,
  3. Richard Brown3
  1. 1Department of Paediatric Neurology, Addenbrookes Hospital, Cambridge, UK
  2. 2Paediatric Intensive Care Unit, University of Cambridge, Addenbrookes Hospital, Cambridge, UK
  3. 3Department of Paediatrics, Peterborough City Hospital, Peterborough, UK
  1. Correspondence to Dr Richard Brown, Department of Paediatrics, Peterborough City Hospital, Bretton Gate, Peterborough PE3 9GZ, UK; Richard.Brown{at}pbh-tr.nhs.uk

Abstract

Most paediatricians will have faced the challenge of managing respiratory problems in the child with severe neurological impairment. These children are under-represented in clinical trials, and data is therefore often extrapolated from other groups, for example children with cystic fibrosis. This means that robust evidence for respiratory management in children with severe neurological impairment is often lacking. Here we have attempted to piece together the existing evidence to provide a rational approach to the management of respiratory problems in children with severe neurological impairment. We also hope to highlight areas of uncertainty, in order to aid honest discussions with families. The respiratory management of the child with neuromuscular disease is beyond the scope of this article.

  • Neurodisability
  • Neurology
  • Ethics
  • General Paediatrics
  • Respiratory
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