Skip to main content

Pulmonary Management of the Patient with Cerebral Palsy

  • Chapter
  • First Online:
Cerebral Palsy

Abstract

Pulmonary problems are a major source of morbidity and mortality, especially among patients with severe cerebral palsy. The respiratory problem can exist at multiple levels, including the respiratory centers of the brain, airways, lung parenchyma, pulmonary vasculature, and chest wall. Careful assessment and therapies targeted to each are needed to optimize care. Immunization against respiratory diseases is of paramount importance. Invasive management, such as orthopedic procedures, or the institution of mechanical ventilation must be carefully considered in the context of the patient’s medical condition, family’s value system, and capabilities of the home and local medical system.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Evans PM, Alberman E. Certified cause of death in children and young adults with cerebral palsy. Arch Dis Child. 1991;66:325–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Reddihough DS, Baikie G, Walstab JE. Cerebral palsy in Victoria, Australia: mortality and causes of death. J Paediatr Child Health. 2001;37:183–6.

    Article  CAS  PubMed  Google Scholar 

  3. Murphy NA, Hoff C, Jorgensen T, et al. Costs and complications of hospitalizations for children with cerebral palsy. Pediatr Rehabil. 2006;9:47–52.

    Article  CAS  PubMed  Google Scholar 

  4. Arvedson JC. Feeding children with cerebral palsy and swallowing difficulties. Eur J Clin Nutr. 2013;67(Suppl 2):S9–12.

    Article  PubMed  Google Scholar 

  5. Gerdung CA, Tsang A, Yasseen AS, et al. Association between chronic aspiration and chronic airway infection with Pseudomonas Aeruginosa and other gram-negative bacteria in children with cerebral palsy. Lung. 2016;194:307–14.

    Article  PubMed  Google Scholar 

  6. Spiroglou K, Xinias I, Karatzas N, Panteliadis C, et al. Gastric emptying in children with cerebral palsy and gastroesophageal reflux. Pediatr Neurol. 2004;31:177–82.

    Article  PubMed  Google Scholar 

  7. Vianello IA, Carraro E, Pipitone E, et al. Clinical and pulmonary function markers of respiratory exacerbation risk in subjects with quadriplegic cerebral palsy. Respir Care. 2015;60:1431–7.

    Article  PubMed  Google Scholar 

  8. Seddon PC, Khan Y. Respiratory problems in children with neurological impairment. Arch Dis Child. 2003;88:75–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kwon YH, Lee HY. Differences of the Truncal expansion and respiratory function between children with spastic diplegic and hemiplegic cerebral palsy. J Phys Ther Sci. 2013;25:1633–5.

    Article  PubMed  Google Scholar 

  10. Kwon YH, Lee HY. Differences of respiratory function according to level of the gross motor function classification system in children with cerebral palsy. J Phys Ther Sci. 2014;26:389–91.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lee HY, Kim K. Can walking ability enhance the effectiveness of breathing exercise in children with spastic cerebral palsy? J Phys Ther Sci. 2014;26:539–42.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rousseau MC, Guillotel B. Risk factors for deep venous thrombosis in tetraparesic mentally retarded patients. Brain Inj. 2001;15:1041–4.

    Article  CAS  PubMed  Google Scholar 

  13. Ohmori H, Kanaoka Y, Murata Y, et al. Deep vein thrombosis in patients with severe motor and intellectual disabilities, especially diagnosis and prevention of recurrence for chronic thrombosis - serial changes of Sonography and D-dimer. Ann Vasc Dis. 2015;8:290–6.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Kwon YH, Lee HY. Differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy in comparison with normal controls. J Phys Ther Sci. 2015;27:401–3.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lampe R, Blumenstein T, Turova V, Alves-Pinto A. Lung vital capacity and oxygen saturation in adults with cerebral palsy. Patient Prefer Adherence. 2014;8:1691–7.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sharma GD. Pulmonary function testing in neuromuscular disorders. Pediatrics. 2009;123(Suppl 4):S219–21.

    Article  PubMed  Google Scholar 

  17. Garcia J, Wical B, Wical W, et al. Obstructive sleep apnea in children with cerebral palsy and epilepsy. Dev Med Child Neurol. 2016;58:1057–62.

    Article  PubMed  Google Scholar 

  18. Coudeville L, Vanrie A, Andre P. Adult pertussis vaccination strategies and their impact on pertussis in the United States: evaluation of routine and targeted (cocoon) strategies. Epidemiol Infect. 2007;136:604–20.

    PubMed  PubMed Central  Google Scholar 

  19. Whitaker AT, Sharkey M, Diab M. Spinal fusion for scoliosis in patients with globally involved cerebral palsy: an ethical assessment. J Bone Joint Surg Am. 2015;97:782–7.

    Article  PubMed  Google Scholar 

  20. Keskinen H, Lukkarinen H, Korhonen K, et al. The lifetime risk of pneumonia in patients with neuromuscular scoliosis at a mean age of 21 years: the role of spinal deformity surgery. J Child Orthop. 2015;9:357–64.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Cassidy C, Craig CL, Perry A, et al. A reassessment of spinal stabilization in severe cerebral palsy. J Pediatr Orthop. 1994;14:731–9.

    Article  CAS  PubMed  Google Scholar 

  22. McElroy MJ, Sponseller PD, Dattilo JR, et al. Growing rods for the treatment of scoliosis in children with cerebral palsy: a critical assessment. Spine (Phila 1976). 2012;37:E1504–10.

    Article  Google Scholar 

  23. Watanabe K, Lenke LG, Daubs MD, et al. Is spine deformity surgery in patients with spastic cerebral palsy truly beneficial?: a patient/parent evaluation. Spine (Phila Pa 1976). 2009;34:2222–32.

    Article  Google Scholar 

  24. Walshe M, Smitth M, Penningtn L. Interventions for drooling in children with cerebral palsy. Cochrane Database Syst Rev. 2012;11:CD008624.

    PubMed  Google Scholar 

  25. Srivastava R, Downey EC, Ogorman M, et al. Impact of fundoplication versus Gastrojejunal feeding tubes on mortality and in preventing aspiration pneumonia in young children with neurologic impairment who have gastroesophageal reflux disease. Pediatrics. 2009;123:338–45.

    Article  PubMed  Google Scholar 

  26. Care of the Child with a Chronic Tracheostomy. Am J Resp Crit Care Med. 2000;161:297–308.

    Article  Google Scholar 

  27. Plioplys AV, Kasnicka I. Nebulized tobramycin: prevention of pneumonias in patients with severe cerebral palsy. J Pediatr Rehabil Med. 2011;4:155–8.

    PubMed  Google Scholar 

  28. Fitzgerald DA, Follett J, Van Asperen PP. Assessing and managing lung disease and sleep disordered breathing in children with cerebral palsy. Paediatr Respir Rev. 2009;10:18–24.

    Article  PubMed  Google Scholar 

  29. Plioplys AV, Lewis S, Kasnicka I. Pulmonary vest therapy in pediatric long-term care. J Am Med Dir Assoc. 2002;3:318–21.

    Article  PubMed  Google Scholar 

  30. Yuan N, Kane P, Shelton K, et al. Safety, tolerability, and efficacy of high-frequency chest wall oscillation in pediatric patients with cerebral palsy and neuromuscular diseases: an exploratory randomized controlled trial. J Child Neurol. 2010;25:815–21.

    Article  PubMed  Google Scholar 

  31. Birnkrant DJ, Bushby KM, Amin RS, et al. The respiratory management of patients with Duchenne muscular dystrophy: a DMD care considerations working group specialty article. Pediatr Pulmonol. 2010;45:739–48.

    Google Scholar 

  32. Choi JY, Rha DW, Park ES. Change in pulmonary function after incentive spirometer exercise in children with spastic cerebral palsy: a randomized controlled study. Yonsei Med J. 2016;57:769–75.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lee HY, Cha YJ, Kim K. The effect of feedback respiratory training on pulmonary function of children with cerebral palsy: a randomized controlled preliminary report. Clin Rehabil. 2014;28:965–71.

    Article  PubMed  Google Scholar 

  34. Schwantes S, Wells O’Brien H. Pediatric palliative care for children with complex chronic medical conditions. Pediatr Clin N Am. 2014;61:797–821.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Garey Noritz M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Noritz, G. (2018). Pulmonary Management of the Patient with Cerebral Palsy. In: Panteliadis, C. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-67858-0_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-67858-0_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67857-3

  • Online ISBN: 978-3-319-67858-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics