Physiotherapy, Perth Children's Hospital, Nedlands, WA, Australia.
Research, Ability Centre, Mount Lawley, WA, Australia.
Dev Med Child Neurol. 2021 Feb;63(2):172-182. doi: 10.1111/dmcn.14640. Epub 2020 Aug 9.
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.
呼吸系统疾病是脑瘫(CP)儿童死亡的主要原因。尽管已经确定了发生慢性呼吸系统疾病的危险因素,但目前尚无针对预防和管理呼吸系统疾病的综合临床护理建议。我们邀请了 200 多名来自多个学科的临床医生和研究人员,他们在 CP 儿童呼吸系统疾病的管理方面具有专业知识,采用 RAND 公司-加州大学洛杉矶分校适宜性方法(RAND Corporation-University of California Los Angeles Appropriateness Method)对护理建议进行了修改德尔菲法(modified Delphi method)的制定。这些建议旨在供广泛照顾 CP 患者的医生使用。它们为识别多因素原发性和继发性潜在可改变的危险因素以及提供协调的多学科护理提供了一个框架。我们描述了生成共识建议的方法,以及评估、预防和治疗 CP 儿童呼吸系统疾病的总体观点。本文的新增内容:用于预防和管理脑瘫(CP)呼吸疾病的首份共识声明。CP 患者的呼吸疾病危险因素应及早识别。有呼吸疾病风险的 CP 患者需要定期评估危险因素。多学科团队、CP 患者和家属之间的有效合作至关重要。CP 患者的呼吸疾病治疗必须具有前瞻性。