Box 5
Management of respiratory problems in children with neurodisability (ND)6
Aspiration
- Antireflux medication, fundoplication
- Feed thickeners, gastrostomy feeding, individualised feeding plan
- Anticholinergics, salivary gland botulinum injections and clipping
Impaired chest clearance
- Individualised physiotherapy
- Mucolytics and bronchodilators
Infection
- Proactive treatment and longer courses of antibiotics
- Antibiotic prophylaxis
- Immunisations
Upper airways obstruction
- Airway adjuncts
- Adenotonsillectomy
- Oxygen, CPAP
Impaired respiratory excursion and hypoventilation
- Individualised seating arrangements (occupational therapy)
- Spinal surgery if appropriate
- BiPAP (bilevel) respiratory support
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