From the Guidelines
Management of cerebral palsy secretions should prioritize a multi-faceted approach, including airway clearance techniques such as manually assisted cough, mechanical insufflation-exsufflation devices, and lung volume recruitment, as recommended by the most recent guidelines 1.
Key Considerations
- Patients with cerebral palsy and excessive secretions should be referred to a specialist respiratory service for consideration of airway clearance support, particularly if they have a compromised cough or frequent chest infections 1.
- Techniques such as breath stacking, lung volume recruitment, and manually assisted cough can be beneficial for inspiration and forced expiration 1.
- Mechanical insufflation-exsufflation devices should be considered for patients with significantly impaired cough, with individualized settings and a suitable interface 1.
Airway Clearance Techniques
- Manually assisted cough and mechanical insufflation-exsufflation devices can be effective in clearing secretions and preventing respiratory complications 1.
- Lung volume recruitment and breath stacking can also be used to improve lung function and reduce secretion retention 1.
Additional Interventions
- Proper positioning, regular suctioning, and physical therapy focusing on strengthening swallowing muscles and improving oral motor control can also be beneficial in managing cerebral palsy secretions 1.
- Adequate hydration and thickening agents for liquids may also be considered to prevent thickening of secretions and reduce aspiration risk 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Cerebral Palsy Secretions
- Cerebral palsy (CP) is a neurodevelopmental disorder that can cause various symptoms, including excessive drooling or salivary secretions 2.
- Drooling in children with cerebral palsy can lead to aspiration pneumonia, which can be a significant health concern 3, 4.
- Treatment options for drooling in children with cerebral palsy include:
- Botulinum toxin type A (BoNT-A) injections into the salivary glands, which have been shown to be safe and effective in reducing drooling and aspiration pneumonia 3, 4.
- Anticholinergic medications, such as glycopyrrolate, which can help reduce salivary secretions 5, 6.
- Nebulized glycopyrrolate, which has been shown to be effective in managing posterior drooling in patients with brain injury, including cerebral palsy 6.
- The management of cerebral palsy involves a multidisciplinary approach, including neurological rehabilitation, physical and occupational therapies, and diagnosis and management of co-morbidities 2.