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Arch Dis Child Educ Pract Ed 98:84-91 doi:10.1136/archdischild-2012-302324
  • Best practice

Outpatient respiratory management of the child with severe neurological impairment

  1. 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
  • Received 7 November 2012
  • Revised 26 February 2013
  • Accepted 13 March 2013
  • Published Online First 18 April 2013

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.

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