了解和管理神经功能障碍儿童和青年呼吸道感染。

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-03-01 DOI:10.1080/17476348.2023.2192483
Marijke Proesmans, Francois Vermeulen, Mieke Boon
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引用次数: 0

摘要

神经认知障碍(NI)患者有多种医疗需求,呼吸问题导致生活质量和预期寿命显著下降。我们的目的是解释NI患者慢性呼吸道症状的起源是多因素的。研究领域:NI患者中,吞咽功能障碍和唾液过多导致误吸的发生率很高;咳嗽疗效下降导致慢性肺部感染;睡眠呼吸紊乱频繁,肌肉质量因营养不良而异常。技术调查并不总是足够具体和敏感,无法更好地诊断呼吸道症状的原因;此外,在这一脆弱的患者群体中,它们有时很难执行。我们提供了一种临床途径来识别、预防和治疗患有NI的儿童和年轻人的呼吸系统并发症。强烈建议与所有护理人员和家长讨论一个全面的方法。专家意见:对NI和慢性呼吸系统疾病患者的护理具有挑战性。几个致病因素之间的相互作用可能很难弄清楚。在这一领域进行良好的临床研究在很大程度上是缺失的,应该鼓励。只有这样,循证临床护理才有可能针对这一弱势患者群体。
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Understanding and managing respiratory infections in children and young adults with neurological impairment.

Introduction: Patients with neurocognitive impairment (NI) have multiple medical needs, with respiratory problems leading to an important reduction in quality of life and life expectancy. We aimed to explain that the origin of chronic respiratory symptoms in patients with NI is multifactorial.

Areas covered: In people with NI there is a high prevalence of swallowing dysfunction and hypersalivation inducing aspiration; cough efficacy is decreased resulting in chronic lung infection; sleep-disordered breathing is frequent and muscle mass is abnormal due to malnutrition. Technical investigations are not always specific and sensitive enough to better diagnose the causes of the respiratory symptoms; moreover, they can sometimes be difficult to perform in this vulnerable patient population. We provide a clinical pathway to adopt to identify, prevent, and treat respiratory complications in children and young adults with NI. A holistic approach in discussion with all care providers and the parents is highly recommended.

Expert opinion: The care for people with NI and chronic respiratory problems is challenging. The interplay between several causative factors may be difficult to entangle. Well-performed clinical research in this field is largely missing and should be encouraged. Only then, evidence-based clinical care will become possible for this vulnerable patient group.

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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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