The respiratory problems of patients with cerebral palsy requiring hospitalization: Reasons and solutions.

Abstract

Recurrent respiratory problems are common in patients with cerebral palsy (CP). Detection of risk factors could prevent respiratory problems and reduce permanent lung damage. We aimed to provide a multidisciplinary approach for the causes, frequency, and concomitant problems and solutions of respiratory problems of these patients. Medical records of CP patients who were followed-up and treated due to respiratory problems requiring hospitalization were examined retrospectively, and factors affecting the frequency and duration of hospitalization in wards and in the intensive care unit (ICU) were evaluated. Among 292 hospitalizations of 83 CP patients, 91% of them were hospitalized for pneumonia, and only 15.4% of them had major aspiration-related pneumonia in the history. 97.4% of the hospitalized patients had swallowing dysfunction in detailed history, but videofluoroscopic swallowing studies could be performed only to 24 patients and aspiration had been demonstrated in 96%. Patients who had been hospitalized more than two times during the oral feeding period, before switching to artificial feeding (nasogastric tube, gastric tube +/- fundoplication), had higher total and ICU hospitalization frequency/duration than the patients who had been hospitalized twice or less (0.12 vs. 0.17/0.005106 vs. 0.005353). The most common pulmonary complication in patients with CP is pneumonia due to chronic aspiration. To prevent recurrent lung infections and consequently chronic respiratory failure, it is necessary to evaluate these patients in terms of feeding difficulties in the early period with appropriate methods and apply interventions before affecting the lung parenchyma.