Respiratory hospital admissions and emergency department visits in young people with cerebral palsy: 5-year follow-up

Blackmore, Amanda Marie; Bear, Natasha; Langdon, Katherine; Moshovis, Lisa; Gibson, Noula; Wilson, Andrew

doi:10.1136/archdischild-2019-317714

Cited by 15 publications

(23 citation statements)

References 4 publications

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“…These risk factors are shown in Figure S1 (online supporting information). An interactive online tool has been developed to identify children and young people with CP who have relevant risk factors for developing respiratory disease 11,13,19,20 . The tool can be found at https://www.abilitycentre.com.au/resources/cpchecklist.…”

Section: Part 1: Recognizing and Managing Risks To Prevent Respiratormentioning

confidence: 99%

“…There are no studies on interventions for the prevention of respiratory disease in young people with CP who are at risk. Now that risk factors are known, 12,13,19 it is recommended that preventative interventions for these children be explored.…”

Section: Future Researchmentioning

confidence: 99%

“…Recognizing respiratory risk in individuals with CP is everyone’s role. Recent research has identified nine risk factors 13,19,20 . A young person with CP who has any of these risk factors is more likely to have at least one hospital admission for chest infections in the next 5 years.…”

Section: Part 1: Recognizing and Managing Risks To Prevent Respiratormentioning

confidence: 99%

“…9 Recent research identifying risk factors for respiratory disease in young people with CP may be used to identify these children earlier. [11][12][13] However, there is insufficient research evidence, nor any consensus statements among practitioners, on how to prevent or manage respiratory disease in young people with CP. 14 Thus, we developed this consensus statement.…”

mentioning

confidence: 99%

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Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement

Gibson

Blackmore²,

Chang

et al. 2020

Develop Med Child Neuro

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Respiratory illness is the leading cause of mortality in children with cerebral palsy (CP). Although risk factors for developing chronic respiratory illness have been identified, comprehensive clinical care recommendations for the prevention and management of respiratory illness do not currently exist. We invited over 200 clinicians and researchers from multiple disciplines with expertise in the management of respiratory illness in children with CP to develop care recommendations using a modified Delphi method on the basis of the RAND Corporation-University of California Los Angeles Appropriateness Method. These recommendations are intended for use by the wide range of practitioners who care for individuals living with CP. They provide a framework for recognizing multifactorial primary and secondary potentially modifiable risk factors and for providing coordinated multidisciplinary care. We describe the methods used to generate the consensus recommendations, and the overall perspective on assessment, prevention, and treatment of respiratory illness in children with CP.

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Section: Part 1: Recognizing and Managing Risks To Prevent Respiratormentioning

confidence: 99%

Section: Future Researchmentioning

confidence: 99%

Section: Part 1: Recognizing and Managing Risks To Prevent Respiratormentioning

confidence: 99%

mentioning

confidence: 99%

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Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement

Gibson

Blackmore²,

Chang

et al. 2020

Develop Med Child Neuro

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“…A prospective data-linkage study with young people with CP identified factors significantly associated with subsequent respiratory hospitalizations over a 5-years period. They included: GMFCS Level V, at least one respiratory hospital admission in the previous year, at least two courses of antibiotics in the previous year, oropharyngeal dysphagia, frequent respiratory symptoms (daily cough, or weekly sounding chesty, phlegmy, or wheezy), current seizures, GER, mealtime symptoms when well (gurgly voice, wheezing, coughing, sneezing, choking), and nightly snoring ( 20 , 21 ).…”

Section: Risk Factors For Respiratory Illnessmentioning

confidence: 99%

Evaluation and Management of Respiratory Illness in Children With Cerebral Palsy

et al. 2020

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Cerebral palsy (CP) is the most common cause of disability in childhood. Respiratory illness is the most common cause of mortality, morbidity, and poor quality of life in the most severely affected children. Respiratory illness is caused by multiple and combined factors. This review describes these factors and discusses assessments and treatments. Oropharyngeal dysphagia causes pulmonary aspiration of food, drink, and saliva. Speech pathology assessments evaluate safety and adequacy of nutritional intake. Management is holistic and may include dental care, and interventions to improve nutritional intake, and ease, and efficiency of feeding. Behavioral, medical, and surgical approaches to drooling aim to reduce salivary aspiration. Gastrointestinal dysfunction, leading to aspiration from reflux, should be assessed objectively, and may be managed by lifestyle changes, medications, or surgical interventions. The motor disorder that defines cerebral palsy may impair fitness, breathing mechanics, effective coughing, and cause scoliosis in individuals with severe impairments; therefore, interventions should maximize physical, musculoskeletal functions. Airway clearance techniques help to clear secretions. Upper airway obstruction may be treated with medications and/or surgery. Malnutrition leads to poor general health and susceptibility to infection, and improved nutritional intake may improve not only respiratory health but also constipation, gastroesophageal reflux, and participation in activities. There is some evidence that children with CP carry pathogenic bacteria. Prophylactic antibiotics may be considered for children with recurrent exacerbations. Uncontrolled seizures place children with CP at risk of respiratory illness by increasing their risk of salivary aspiration; therefore optimal control of epilepsy may reduce respiratory illness. Respiratory illnesses in children with CP are sometimes diagnosed as asthma; a short trial of asthma medications may be considered, but should be discontinued if ineffective. Overall, management of respiratory illness in children with CP is complex and needs well-coordinated multidisciplinary teams who communicate clearly with families. Regular immunizations, including annual influenza vaccination, should be encouraged, as well as good oral hygiene. Treatments should aim to improve quality of life for children and families and reduce burden of care for carers.

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Determinants of Hospital-Based Health Service Utilization in Cerebral Palsy: a Systematic Review

Paget

Ostojic

Goldsmith

et al. 2022

Archives of Physical Medicine and Rehabilitation

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Respiratory hospital admissions and emergency department visits in young people with cerebral palsy: 5-year follow-up

Cited by 15 publications

References 4 publications

Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement

Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement

Evaluation and Management of Respiratory Illness in Children With Cerebral Palsy

Determinants of Hospital-Based Health Service Utilization in Cerebral Palsy: a Systematic Review

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