Prevalence of long-term mechanical insufflation-exsufflation in children with neurological conditions: a population-based study.

Abstract:

AIM:To determine the prevalence of long-term mechanical insufflation-exsufflation (MI-E) and concomitant mechanical ventilation in children with neurological conditions, with reported reasons behind the initiation of treatment. METHOD:This was a population-based, cross-sectional study using Norwegian national registries and a questionnaire. RESULTS:In total, 114 of 19 264 children with a neurological condition had an MI-E device. Seventy-three of 103 eligible children (31 females, 42 males), median (min-max) age of 10 years 1 month (1y 5mo-17y 10mo), reported their MI-E treatment initiation. Overall, 76% reported airway clearance as the main reason to start long-term MI-E. A prophylactic use was mainly reported by children with neuromuscular disorders (NMDs). Prevalence and age at initiation differed by diagnosis. In spinal muscular atrophy and muscular dystrophies, MI-E use was reported in 34% and 7% of children, of whom 83% and 57% respectively received ventilator support. One-third of the MI-E users were children with central nervous system (CNS) conditions, such as cerebral palsy and degenerative disorders, and ventilator support was provided in 31%. The overall use of concomitant ventilatory support among the long-term MI-E users was 56%. INTERPRETATION:The prevalence of MI-E in a neuropaediatric population was 6 per 1000, with two-thirds having NMDs and one-third having conditions of the CNS. The decision to initiate MI-E in children with neurological conditions relies on clinical judgment.

journal_name

Dev Med Child Neurol

authors

Hov B,Andersen T,Toussaint M,Vollsaeter M,Mikalsen IB,Indrekvam S,Hovland V

doi

10.1111/dmcn.14797

subject

Has Abstract

pub_date

2021-01-03 00:00:00

eissn

0012-1622

issn

1469-8749

pub_type

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