title: Respiratory morbidity in children with profound intellectual and multiple disability.
abstract: BACKGROUND
  'Profound intellectual and multiple disability' (PIMD) is defined as a profound cognitive disability with severe sensory and motor impairments. The aim of this study was to evaluate the respiratory morbidity in children with PIMD and investigate possible risk factors.
  
  
  METHODS
  In 10 specialized facilities for daily care of patients with PIMD, children underwent a standardized clinical assessment evaluating respiratory and motor function. Additional medical information was obtained.
  
  
  RESULTS
  One hundred and twenty seven children aged 2-21 years were tested (median age 12 years; IQR 8-16). 72% had epilepsy, 42% were gastrostomy fed. The median number of lower airway infection per years was four (IQR 1-4). While 68% of patient had no hospital admissions for respiratory disease, 12% of patients were admitted three times or more. Chronic antibiotic therapy was prescribed to nine patients (7%), and 19 patients (15%) were chronically treated with mucolytics, inhaled corticosteroids and/or bronchodilators. Chest physiotherapy was given daily to 26 patients (22%). Gastroesophageal reflux, swallowing problem and aspiration increased the risk for hospital admissions. Additionally risk factors were the severity of disability, axial hypotonia, presence of epilepsy, scoliosis, limited shoulder movement, paradoxical breathing and absence of a spontaneous cough reflex.
  
  
  CONCLUSIONS
  The overall respiratory morbidity in our sample of children with PIMD was lower than anticipated. While a subgroup of children are prone to recurrent severe airway problems, the majority of children did not experience severe airway infections.
authors.affiliation: Department of pediatric pulmonology, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Proesmans
authors.affiliation: Department of pediatric pulmonology, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Vreys
authors.affiliation: Department of pediatric pulmonology, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Huenaerts
authors.affiliation: Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Haest
authors.affiliation: Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Coremans
authors.affiliation: Department of pediatric pulmonology, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Vermeulen
authors.affiliation: Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Feys
mesh_terms: D000293:Adolescent; D001530:Belgium / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000453:epidemiology; D006233:Persons with Disabilities; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D009123:Muscle Hypotonia / Q000453:epidemiology; D053120:Respiratory Aspiration / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012307:Risk Factors; D012600:Scoliosis / Q000453:epidemiology; D055815:Young Adult
keywords: neurocognitive impairment; respiratory tract infections; risk factors