Respiratory problems in children with neurological impairment

Seddon, Paul; Khan, Yasmin

doi:10.1136/adc.88.1.75

Cited by 278 publications

(256 citation statements)

References 25 publications

Supporting

Mentioning

235

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, it is often assumed that a linear relationship exists between the severity of oropharyngeal aspiration and the development respiratory compromise or disease (Cass 2005;Seddon 2003). Taniguchi and Moyer described (using a case control study) that abnormal MBS is a risk factor for pneumonia in children (Taniguchi 1994).…”

Section: Discussionmentioning

confidence: 99%

“…Current practice following detection of aspiration on any consistency during an MBS is to implement swallowing strategies or indirect intervention techniques such as alterations in postural variations and food characteristics such as temperature, viscosity, and texture (Newman 2000;Arvedson 1997;Seddon 2003). Fluid consistencies are the most commonly aspirated material in people with swallowing dysfunction (Arvedson 1994;Rogers 1994;Taniguchi 1994;Morton 1999;Friedman 2000;Lefton-Greif 2000).…”

Section: B a C K G R O U N Dmentioning

confidence: 99%

See 1 more Smart Citation

Restriction of oral intake of water for aspiration lung disease in children

Weir

McMahon

Chang

2012

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: B a C K G R O U N Dmentioning

confidence: 99%

Restriction of oral intake of water for aspiration lung disease in children

Weir

McMahon

Chang

2012

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

“…28 The increase in chest wall mass from obesity further increases the load against which the already weakened respiratory muscles must work, leading to further muscle fatigue and a worsened cough. 5,29 Chest wall compliance is further altered by obesity, making for a more ineffective cough, as described earlier. On the other extreme, malnutrition secondary to inadequate caloric intake decreases muscle mass and leads to a diminished cough.…”

Section: Measurement Of Cough Effectivenessmentioning

confidence: 95%

“…On the other extreme, malnutrition secondary to inadequate caloric intake decreases muscle mass and leads to a diminished cough. 5,17,28 Aspiration (of normal oral secretions, food, and/or liquids) is frequently seen secondary to impaired swallowing 27,29 and can further worsen any underlying lung disease by adding to the burden of a weakened cough. 27 Gastroesophageal reflux can lead to increased risk for aspiration 29 and can be worsened by obesity as well as scoliosis.…”

Section: Measurement Of Cough Effectivenessmentioning

confidence: 99%

Airway Clearance in Duchenne Muscular Dystrophy

Kravitz

2009

Pediatrics

View full text Add to dashboard Cite

This is a summary of the presentation on airway clearance in neuromuscular disorders presented as part of the program on airway clearance in Duchenne muscular dystrophy at the 30th annual Carrell-Krusen Neuromuscular Symposium on February 20, 2008. Pediatrics 2009123:S231-S235 D UCHENE MUSCULAR DYSTROPHY (DMD) is an X-linked recessive hereditary disease that affects both skeletal and cardiac muscle. [1][2][3][4][5] The protein dystrophin is made in inadequate amounts, which leads to the break down of muscle cell walls and the cell's ultimate death. This loss of muscle leads to numerous problems including axial skeletal muscle weakness and the loss of ambulation, diaphragmatic weakness with recurrent pneumonias and progressive respiratory failure, and cardiomyopathy with arrhythmias. [2][3][4][5] The combination of cardiopulmonary failure leads to early death, with the mean life span of affected males being ϳ25 years. 1,2,[4][5][6][7] Although there is currently no cure for DMD, supportive therapies can markedly decrease the morbidity of this condition, thus prolonging the life span of these young men and improving their quality of life. This review will focus on airway clearance and cough augmentation as ways of decreasing the incidence of atelectasis, pneumonia, and respiratory failure associated with this muscular dystrophy. NORMAL COUGHCoughing works by helping to clear airway secretions from the lungs. [8][9][10][11] These secretions act as a protective layer covering the bronchi and bronchioles. They trap environmental particulate matter as well as bacteria and viruses that are inhaled during respiration. 8,11 Cilia protruding from bronchial epithelial cells move this protective layer in a proximal direction. 11 Coughing augments the ciliary clearance of these secretions, with the ultimate expectoration or swallowing of this material. 9 Coughing consists of 3 components: an inspiratory phase; a contraction phase; and an expiratory phase. 8,10 During the inspiratory phase, the patient inhales, usually to 60% to 90% of total lung capacity. 2,3,10,12,13 In the contraction phase, the patient's glottis closes and the expiratory muscles begin to contract. This phase lasts only 0.2 seconds; however, during this time, elevated intrathoracic pressures are reached. 8 During the final (expiratory) phase of a cough, the glottis opens, and there is a sudden expiratory rush of air. It is during this phase of the cough that large shearing forces are generated, cleaving off parts of the secretary lining and carrying with them the trapped foreign material. 8,10 During this expiratory phase, velocities as high as 12 m/second can be reached, with flow rates of 360 to 1000 L/minute being obtained for a normal cough. 2,3,8,10,12 Many conditions can lead to an increase in airway secretions. In pediatrics, 2 of the more common etiologies of increased airway secretions include pneumonia and asthma. These illnesses are associated with an increase in airway inflammation and a resultant increase in secretion volume. One of...

show abstract

“…This deformity restricts lung function by reducing both chest wall compliance and the mechanical advantage of respiratory muscles, and can eventually result in pneumonia 1) .…”

Section: Introductionmentioning

confidence: 99%

Reliability of Two Protocols for Measuring Chest Wall Dimensions in the Transverse Plane in Individuals with Severe Motor and Intellectual Disabilities

et al. 2011

View full text Add to dashboard Cite

Abstract.[Purpose] The present study aimed to estimate the reliability of two protocols for measuring chest wall dimensions in the transverse plane in individuals (18 males, 12 females) aged 2 years 6 months to 58 years (mean age 34.7 ± 17.6) with Severe Motor and Intellectual Disabilities (SMID). [Subjects and Methods] For diagnosing pneumonia in individuals with SMID, 30 X-ray computed tomograms were taken at the level of the xiphisternal junction, scanned, and saved on a personal computer. Five therapists examined these images. Anteroposterior (AP) and laterolateral (LL) diameters were measured using two protocols. The largest AP and LL diameters were measured along the gravity line (protocol 1) and along the line where the middle point of the sternum connects with the spinous process of the vertebra (protocol 2). Intraclass correlation coefficients (ICCs) were calculated to estimate the intrarater and interrater reliability of each protocol.[Results] ICCs were >0.85 in protocols 1 and 2 for all measurements, showing these protocols are highly reliable for measuring chest wall dimensions in the transverse plane. [Conclusions] Measurements using these protocols are easy and cheap, and can be performed retrospectively, providing an effective way for evaluating chest wall deformity in individuals with SMID.

show abstract

Respiratory problems in children with neurological impairment

Cited by 278 publications

References 25 publications

Restriction of oral intake of water for aspiration lung disease in children

Restriction of oral intake of water for aspiration lung disease in children

Airway Clearance in Duchenne Muscular Dystrophy

Reliability of Two Protocols for Measuring Chest Wall Dimensions in the Transverse Plane in Individuals with Severe Motor and Intellectual Disabilities

Contact Info

Product

Resources

About