{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:58:53Z","timestamp":1781197133317,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T00:00:00Z","timestamp":1609632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the prevalence of long\u2010term mechanical insufflation\u2010exsufflation (MI\u2010E) and concomitant mechanical ventilation in children with neurological conditions, with reported reasons behind the initiation of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a population\u2010based, cross\u2010sectional study using Norwegian national registries and a questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 114 of 19\u00a0264 children with a neurological condition had an MI\u2010E device. Seventy\u2010three of 103 eligible children (31 females, 42 males), median (min\u2013max) age of 10\u00a0years 1\u00a0month (1y 5mo\u201317y 10mo), reported their MI\u2010E treatment initiation. Overall, 76% reported airway clearance as the main reason to start long\u2010term MI\u2010E. A prophylactic use was mainly reported by children with neuromuscular disorders (NMDs). Prevalence and age at initiation differed by diagnosis. In spinal muscular atrophy and muscular dystrophies, MI\u2010E use was reported in 34% and 7% of children, of whom 83% and 57% respectively received ventilator support. One\u2010third of the MI\u2010E users were children with central nervous system (CNS) conditions, such as cerebral palsy and degenerative disorders, and ventilator support was provided in 31%. The overall use of concomitant ventilatory support among the long\u2010term MI\u2010E users was 56%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The prevalence of MI\u2010E in a neuropaediatric population was 6 per 1000, with two\u2010thirds having NMDs and one\u2010third having conditions of the CNS. The decision to initiate MI\u2010E in children with neurological conditions relies on clinical judgment.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>The prevalence and age at initiation of mechanical insufflation\/exsufflation (MI\u2010E) differed between diagnoses.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>MI\u2010E was most commonly used in spinal muscular atrophy, where it generally coincided with ventilatory support.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>One\u2010third of MI\u2010E devices were given to children with central nervous system conditions, and one\u2010third also received ventilatory support.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14797","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T08:21:17Z","timestamp":1609748477000},"page":"537-544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence of long\u2010term mechanical insufflation\u2010exsufflation in children with neurological conditions: a population\u2010based study"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1535-4146","authenticated-orcid":false,"given":"Brit","family":"Hov","sequence":"first","affiliation":[{"name":"Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway"},{"name":"Institute of Clinical Medicine University of Oslo Oslo 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