Secretion management devices reduce hospitalizations for respiratory exacerbations in children with neurodisability

Background

Respiratory complications are the leading cause of morbidity and mortality in children with neurodisability. Repeated pulmonary infections lead to multiple hospitalizations. Effective secretion management is crucial in this population, but studies on their impact are limited. This study evaluates the effect of secretion management on the duration of hospitalizations for respiratory exacerbations in children with neurodisability.

Methods

This retrospective observational multicenter study included children from four French reference centers, between February and May 2024, one year after initiating a secretion management device.

Results

Twenty-three patients (9 girls) with a median age of 10.7 [8.7; 15.3] years were included. Sixteen children had recurrent chest infections before initiating a secretion management device. Intrapulmonary percussive ventilation (IPV), intermittent positive pressure breathing (IPPB), and mechanical insufflation-exsufflation (MI-E) devices were prescribed to 12, 7, and 5 children, respectively. The primary indication was repeated respiratory infections in 11 children, and thoracic mobilization in 8 children. One year after device initiation, the number of days of hospitalization for pulmonary exacerbation significantly decreased from a median (range) of 12 (0–88) to 0 (0–34) days (p = 0.018).

Conclusion

This multicenter study demonstrates that secretion management significantly reduces the duration of hospitalizations for respiratory exacerbations in children with neurodisability.