Author/Editor		Kopriva, Silvester
Title		Respiracijska insuficienca pri otroku z nevrološko okvaro
Translated title		Respiratory insufficiency in children with neurological deficit
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 37, št. Suppl 4
Publication year		1998
Volume		str. 122-9
Language		slo
Abstract		The article reviews in general the variety of respiratory difficulties arising in children with different neurologicaldisorders and possibly leading to respiratory insufficiency. It presents briefly the pathogenesis of respiratory insufficiency, emphassing the importance of the failing respiratory pump. It shows some disturbances originating in neurological defects, which can impose a damage to the lung,such as aspiratiron or insufficient expectoration. It notes the disturbances of breathing control, since they are one of the causes of respiratory insufficiency, or contributing factor. A similar threat for a child with a neurological deficit can be upper airway obstruction. Duchenne muscular dysthrophy serves as an example which illustrates respiratory changes in neuromuscular diseases terminating in respiratory inssufficincy and which can be overcome with homemechanical ventilation noninvasively with a nose mask or by tracheostomy. It lists other therapeutic procedures (e.g. gastrostomy feeding), which can prevent worsening of respiratory difficulties and frequent hospital admissions, facilitate nursing and improve the quality of life also in gravely and irreversibly neurlogicaly handicaped children. In conclusion the author gives his opinion that a central institution with broader team collaboration is needed for taking care of all children in chronic respiratory insufficiency, including those with neurological deficit.
Summary		Prispevek podaja splošen pregled različnih težav z dihali, ki nastanejo pri otroku z raznimi vrtstami nevrološke okvare in ki lahko vodijo do dihalne odpovedi oz. respiracijske insuficience. Na kratko prikaže patogenezo respiracijske insuficience in poudari pomen odpovedovanja dihalne črpalke. Navaja nekatere motnje, ki nastanejo zaradi nevrološke prizadetosti in ki lahko prizadanejo pljuča, kot so aspiracija ali neučinkovito izkašljevanje. Omenja motnje regulacije dihanja,ker so eden od vzrokov respiracijske insuficience, ali pomemben dejavnik pri njenem nastanku. Enako lahko ogroža otroka z nevrološko okvaro obstrukcija v zgornjih dihalih. Na primeru Duchennove mišične distrofije prispevek prikaže spremembe na dihalih pri živčno-mišičnih boleznih, ki so vzrok končne respiracijske insuficience. Možen ukrep zdravljenja je umetna ventilacija na domu, bodisi na neinvaziven način (nosna maska), bodisi na invaziven način (traheostoma). Našteva še druge posege v poteku zdravljenja (npr. hranilna gastrostoma), ki lahko preprečujejo hujše dihalne težave in pogoste sprejeme v bolnišnico, olajšajo nego in izboljšajo kakovost življenja tudi tistih otrok, ki so nevrološko hudo in brezupno prizadeti. Avtor v zaključku podaja mnenje, da bibila potrebna neka osrednja ustanova s širšim timskim sodelovanjem, ki bi lahko poskrbela za vse otroke s kronično respiracijsko insuficienco, tudi za tiste, ki imajo nevrološko okvaro.
Descriptors		NERVOUS SYSTEM DISEASES RESPIRATORY INSUFFICIENCY CHILD SLEEP APNEA SYNDROMES ANOXEMIA HYPERCAPNIA