关键词: critical care emergency medicine referral and consultation respiratory measurement respiratory muscles

Mesh : Child Adult Humans Muscular Dystrophy, Duchenne / therapy Health Personnel Pulmonologists United Kingdom

来  源:   DOI:10.1136/thorax-2023-220811   PDF(Pubmed)

Abstract:
Significant inconsistencies in respiratory care provision for Duchenne muscular dystrophy (DMD) are reported across different specialist neuromuscular centres in the UK. The absence of robust clinical evidence and expert consensus is a barrier to the implementation of care recommendations in public healthcare systems as is the need to increase awareness of key aspects of care for those living with DMD. Here, we provide evidenced-based and/or consensus-based best practice for the respiratory care of children and adults living with DMD in the UK, both as part of routine care and in an emergency.
METHODS: Initiated by an expert working group of UK-based respiratory physicians (including British Thoracic Society (BTS) representatives), neuromuscular clinicians, physiotherapist and patient representatives, draft guidelines were created based on published evidence, current practice and expert opinion. After wider consultation with UK respiratory teams and neuromuscular services, consensus was achieved on these best practice recommendations for respiratory care in DMD.
RESULTS: The resulting recommendations are presented in the form of a flow chart for assessment and monitoring, with additional guidance and a separate chart setting out key considerations for emergency management. The recommendations have been endorsed by the BTS.
CONCLUSIONS: These guidelines provide practical, reasoned recommendations for all those managing day-to-day and acute respiratory care in children and adults with DMD. The hope is that this will support patients and healthcare professionals in accessing high standards of care across the UK.
摘要:
据报道,英国不同的专科神经肌肉中心在杜兴氏肌营养不良症(DMD)的呼吸护理提供方面存在明显的不一致。缺乏强有力的临床证据和专家共识是公共医疗保健系统中实施护理建议的障碍,因为需要提高对患有DMD的人的护理关键方面的认识。这里,我们为英国患有DMD的儿童和成人的呼吸护理提供基于证据和/或基于共识的最佳实践,作为常规护理和紧急情况的一部分。
方法:由英国呼吸内科专家工作组(包括英国胸科学会(BTS)代表)发起,神经肌肉临床医生,物理治疗师和患者代表,准则草案是根据公布的证据制定的,目前的做法和专家意见。在与英国呼吸团队和神经肌肉服务机构进行广泛协商后,对于DMD中呼吸护理的这些最佳实践建议达成共识.
结果:由此产生的建议以评估和监测流程图的形式呈现,有额外的指导和单独的图表列出了应急管理的关键考虑因素。建议已得到BTS的认可。
结论:这些指南提供了实用的,为所有DMD儿童和成人日常和急性呼吸道护理管理人员提供合理的建议。希望这将支持患者和医疗保健专业人员在英国各地获得高标准的护理。
公众号