Respiratory Complications in Children with Neurological Diseases

To maintain adequate gas exchange and alveolar ventilation, the respiratory system requires an intact parenchyma and a respiratory pump. The failure of any of these components can result in respiratory failure. Neurological disorders affect the respiratory system either through the central nervous system (altering the ventilatory centers, swallowing, and respiratory movements) or through the peripheral nervous system (altering the respiratory pump and its regulatory feedback to the central system). The degree of impairment will depend on the disease, the severity of nerve or muscle involvement, and the timing of the diagnosis. A complete neurological assessment will provide a systemic approach, which must involve a multidisciplinary team. The respiratory system should be evaluated from the clinical and physiological standpoints on a regular basis, following guidelines that include spirometry, static pressure measures, peak flow cough, sleep studies, chest imaging, and bronchoscopy, among other evaluations. The treatment must focus on slowing down the progressive deterioration of musculoskeletal and respiratory function, thus improving the quality of life.