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Breath Collection from Children for Disease Biomarker Discovery
Published on: February 14, 2019
Respiratory morbidity in children with profound intellectual and multiple disability
M Proesmans1, M Vreys1, E Huenaerts1
1Department of pediatric pulmonology, Katholieke Universiteit Leuven, Leuven, Belgium.
Insights
Respiratory morbidity in children with profound intellectual and multiple disability (PIMD) was lower than expected. However, specific risk factors like aspiration and epilepsy increase the likelihood of severe airway issues in a subset of these children.
Area of Science:
- Pediatrics
- Pulmonology
- Neurology
Background:
- Profound intellectual and multiple disability (PIMD) involves profound cognitive, sensory, and motor impairments.
- Understanding respiratory health in this population is crucial due to potential complications.
Purpose of the Study:
- To assess respiratory morbidity in children with PIMD.
- To identify risk factors associated with respiratory issues in this group.
Main Methods:
- A standardized clinical assessment of respiratory and motor function was conducted.
- Data from 127 children (aged 2-21) across 10 specialized facilities were analyzed.
- Medical information, including feeding methods and pre-existing conditions, was collected.
Main Results:
- The median number of lower airway infections was four per year.
- While 68% had no hospital admissions for respiratory disease, 12% were admitted three or more times.
- Gastroesophageal reflux, swallowing problems, aspiration, epilepsy, and physical impairments were identified as risk factors for hospital admissions.
Conclusions:
- Respiratory morbidity in children with PIMD was generally lower than anticipated.
- A significant subgroup faces recurrent severe airway problems, necessitating targeted interventions.
- Risk factors identified can inform preventative strategies and management plans.
Background:
'Profound intellectual and multiple disability' (PIMD) is defined as a profound cognitive disability with severe sensory and motor impairments. The aim of this study was to evaluate the respiratory morbidity in children with PIMD and investigate possible risk factors.
Methods:
In 10 specialized facilities for daily care of patients with PIMD, children underwent a standardized clinical assessment evaluating respiratory and motor function. Additional medical information was obtained.
Results:
One hundred and twenty seven children aged 2-21 years were tested (median age 12 years; IQR 8-16). 72% had epilepsy, 42% were gastrostomy fed. The median number of lower airway infection per years was four (IQR 1-4). While 68% of patient had no hospital admissions for respiratory disease, 12% of patients were admitted three times or more. Chronic antibiotic therapy was prescribed to nine patients (7%), and 19 patients (15%) were chronically treated with mucolytics, inhaled corticosteroids and/or bronchodilators. Chest physiotherapy was given daily to 26 patients (22%). Gastroesophageal reflux, swallowing problem and aspiration increased the risk for hospital admissions. Additionally risk factors were the severity of disability, axial hypotonia, presence of epilepsy, scoliosis, limited shoulder movement, paradoxical breathing and absence of a spontaneous cough reflex.
Conclusion:
The overall respiratory morbidity in our sample of children with PIMD was lower than anticipated. While a subgroup of children are prone to recurrent severe airway problems, the majority of children did not experience severe airway infections.
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