Managing Pulmonary Complications in Adults With Cerebral Palsy: A Vulnerable Transition

Cerebral palsy is the most common motor disability in childhood with increasing survival rates into adulthood. Pulmonary complications are a leading cause of morbidity and mortality in this population. However, adult pulmonologists are rarely trained on how to receive these patients into their practice, including how best to identify and manage pulmonary complications. Quality studies on pulmonary complications in cerebral palsy, both in the adult and pediatric population, are lacking, but we review the available literature to provide an approach for the adult pulmonologist in identifying risk factors for pulmonary complications including aspiration, impaired airway clearance, airways disease, neuromuscular scoliosis and restrictive chest wall disease, sleep-disordered breathing, and hypoventilation. We provide a framework to help manage these pulmonary complications and plan and organize successful multidisciplinary transition of pulmonary care from adolescence to adulthood, largely extrapolating from small pediatric studies, studies on neurodevelopmental disorders in general, international guidelines, and clinical experiences, until more quality studies on this topic are available.