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Updated: Aug 6, 2026
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Understanding neuro-pulmonary dysfunction in children with neurodisability
Nadine Freitag1,2, Rachel Knight Lozano3,2, Shailesh Kolekar4,5
1Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Breathe (Sheffield, England)
|July 22, 2026
Summary
Children with neurodisability face significant respiratory issues due to complex neuro-pulmonary factors. Early, pathophysiology-informed care is crucial for preserving lung health throughout childhood and into adulthood.
Area of Science:
- Pediatric Pulmonology
- Neurodevelopmental Pediatrics
- Respiratory Medicine
Background:
- Children with neurodisability have a high burden of respiratory morbidity, impacting quality of life.
- Respiratory issues stem from neuro-pulmonary pathophysiology evolving during development.
- These problems are a leading cause of hospitalization and long-term lung disease.
Purpose of the Study:
- To review the mechanisms underlying respiratory vulnerability in children with neurodisability.
- To link neuro-pulmonary mechanisms to clinical presentations.
- To identify opportunities for proactive respiratory care.
Main Methods:
- Narrative review synthesizing evidence.
- Examining three interacting domains: central breathing control, neuromuscular function, and respiratory mechanics.
- Integrating mechanistic understanding with clinical reasoning.
Main Results:
- Respiratory vulnerability arises from dysregulated breathing control, impaired neuromuscular function, and altered mechanics.
- Early impairment affects ventilation, airway protection, and clearance.
- Secondary features like sleep-disordered breathing and infections contribute to progressive lung injury.
Conclusions:
- Understanding neuro-pulmonary mechanisms is key to managing respiratory health in this population.
- Proactive, pathophysiology-informed strategies can improve long-term respiratory outcomes.
- Earlier recognition of risk factors and tailored care are essential across developmental stages.
