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Published on: February 2, 2024
Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement
Noula Gibson1,2, Amanda M Blackmore2, Anne B Chang3
1Physiotherapy, Perth Children's Hospital, Nedlands, WA, Australia.
Insights
Children with cerebral palsy (CP) face high risks of respiratory illness. This study provides the first consensus-based care recommendations for preventing and managing respiratory disease in this population.
Area of Science:
- Pediatric Pulmonology
- Neurology
- Rehabilitation Medicine
Background:
- Respiratory illness is a primary cause of mortality in children with cerebral palsy (CP).
- Existing knowledge on risk factors is insufficient for comprehensive clinical care guidelines.
- There is a critical need for standardized recommendations for respiratory illness management in CP.
Purpose of the Study:
- To develop the first consensus-based clinical care recommendations for the prevention and management of respiratory illness in children with CP.
- To establish a framework for recognizing and addressing modifiable risk factors for respiratory disease.
- To guide multidisciplinary care for individuals with CP experiencing respiratory issues.
Main Methods:
- A modified Delphi method was employed, utilizing the RAND Corporation-University of California Los Angeles Appropriateness Method.
- Over 200 multidisciplinary clinicians and researchers with expertise in CP and respiratory illness participated.
- Consensus was reached on assessment, prevention, and treatment strategies.
Main Results:
- The study generated the first comprehensive consensus statement on respiratory disease in CP.
- Key recommendations emphasize early identification and regular assessment of respiratory risk factors.
- The importance of proactive, multidisciplinary care and strong partnerships between care teams, patients, and families was highlighted.
Conclusions:
- Proactive, multidisciplinary care is essential for managing respiratory illness in children with CP.
- Early identification and ongoing assessment of risk factors are crucial for effective prevention and treatment.
- These recommendations provide a vital framework for clinicians caring for individuals with CP.
Abstract:
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. WHAT THIS PAPER ADDS: The first consensus statement for preventing and managing respiratory disease in cerebral palsy (CP). Risk factors for respiratory disease in CP should be identified early. Individuals with CP at risk of respiratory disease require regular assessment of risk factors. Effective partnerships between multidisciplinary teams, individuals with CP, and families are essential. Treatment of respiratory disease in individuals with CP must be proactive.
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