British Thoracic Society Guideline for Respiratory Management of Children with Neuromuscular Weakness
Thorax
Hull, J., Aniapravan, R., et al. (2012).
Thorax, 67 Suppl 1, i1-i40.
This guideline provides recommendations for the assessment and treatment of children with neuromuscular weakness (NMW). The target audiences of this guideline are healthcare professionals who care for these children. The guideline provides graded evidence statements and recommendations.
British Thoracic Society
"A problem-oriented approach to nutrition should aim to minimize risk of aspiration, optimize nutritional status, promote comfort, and balance the positive social consequences of continued oral feeding" (Good Practice Point; p. i26).
In boys with Duchenne muscular dystrophy, advancing age leads to increased oral and pharyngeal dysfunction (Evidence Level 3).
Children with neuromuscular weakness and a history of recurrent chest infections or swallowing difficulties should have "a feeding assessment by a speech and language therapist including a videofluoroscopy swallow assessment if the swallow is thought to be unsafe" (Good Practice Point; p. i1).
"Feeding and swallowing difficulties are common in children with neuromuscular disease and are frequently under-recognized" (Evidence Level 2; p. i26).
