First guidelines for respiratory illness in children with cerebral palsy

Infectious diseases

By Michael Woodhead

18 Nov 2020

Dr Andrew Wilson

Australian clinicians have led international efforts to develop the first clinical care recommendations for preventing and managing respiratory illness in children with cerebral palsy (CP).

The consensus statement developed by respiratory specialists at the Perth Children’s Hospital is aimed at tackling the leading cause of mortality in children with CP.

The guidance was developed in response to growing concerns about the ‘silent’ nature of respiratory illness in CP where warning signs are often only recognised when it is too late, says co-author Dr Andrew Wilson, PCH Head of Respiratory Medicine.

Produced in conjunction with researchers from the Physiotherapy Department and KidsRehab WA, and with input from 100 clinicians and researchers worldwide, the guidance will hopefully drive greater awareness and better management of the risk factors for respiratory illness in children and young people with CP, he says

“Our aim through this multi-disciplinary and collaborative approach is to reduce hospital admissions, improve the quality of life and the survival rates of these children.”

“The response we’ve received reflects the fact we’ve identified a genuine area of need which has been significantly under-researched until now,” said Dr Wilson.

A key theme of the guidelines is that the nine risk factors for respiratory disease in CP should be identified early.

The risk factors include:

  • Difficulty controlling head and body posture;
  • Recent hospital admission for respiratory illness;
  • Swallowing difficulties;
  • Current seizures;
  • Frequent symptoms such as cough, wheeze, phlegm or gurgly chest
  • Gastric reflux disease;
  • Chest infections;
  • Mealtime respiratory symptoms;
  • Snoring every night.

Treatment recommendations include guidance on use of antibiotics for respiratory infections and physiotherapy for airway clearance.

The statement has generated a strong response internationally including from the American Academy of Cerebral Palsy and Developmental Medicine who are already promoting it within their practice pathways for clinicians in the US.

“Our multi-disciplinary research team will lead a comprehensive rollout of information which I have no doubt will improve our treatment of this lung disease and most importantly help these kids and their families breathe easier,” said Dr Wilson.

The next step will be testing the recommendations from the consensus statement and developing tools to train GP and allied health professionals who work with CP kids, including speech pathologists and physiotherapists.

The consensus statement is published in the Developmental Medicine and Child Neurology Journal.

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