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Chapter 20 - Respiratory Issues in Children with Neurological Disorders

Published online by Cambridge University Press:  26 May 2025

By
Samiran Ray ,
Lisa Edel  and
Elaine Chan
Edited by
Martin Groß ,
Eelco F. M. Wijdicks ,
Maxwell S. Damian  and
Oliver Summ
Martin Groß
Affiliation:
MEDIAN Clinic Bad Tennstedt
Eelco F. M. Wijdicks
Affiliation:
Mayo Clinic
Maxwell S. Damian
Affiliation:
Basildon University Hospitals
Oliver Summ
Affiliation:
Evangelisches Krankenhaus Oldenburg
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Summary

Neurological disorders in children encompass a heterogeneous group of conditions, congenital or acquired, that are often associated with significant respiratory morbidity. In considering the impact on the respiratory system that are relevant in children with neurological disorders, the phenotypes can be broadly classified into (1) impaired respiratory drive; (2) loss of airway protection/patency; (3) neuromuscular weakness; and (4) reduced or elevated muscle tone. These are not mutually exclusive. In this chapter, the authors review the pathophysiology of respiratory impairment in children with neurological disorders, in the context of childhood development, and discuss the principles behind long-term management of respiratory issues, including monitoring and therapies available to optimize respiratory function. Acute management strategies, including in the pediatric intensive care unit are discussed, alongside the ethical dilemmas faced by clinicians treating this patient population. The lack of high-quality evidence makes management of respiratory issues in children with severe neurological impairments challenging.

Keywords

neurological disorders in childrenpathophysiologychild development and respirationrespiratory managementethical problems

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Type
Chapter
Information
Clinical Neurorespiratory Medicine , pp. 263 - 281
Publisher: Cambridge University Press
Print publication year: 2025

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