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Aim: To (1) compare the perceived benefit of long‐term mechanical insufflation‐exsufflation (MI‐E) of children with neuromuscular disorders (NMDs) and central nervous system (CNS) disorders, including health care needs and treatment routines and (2) describe the children's health‐related quality of life (HRQoL). Method: This cross‐sectional study used a questionnaire and memory card data to assess the perceived benefit of MI‐E via the Visual Analogue Scale (VAS; 10 maximum), willingness to pause treatment, level of health care needs before and after MI‐E initiation, and the children's treatment routines. A DISABKIDS questionnaire assessed HRQoL (100 maximum). Results: Seventy‐three children using MI‐E participated (42 males, median [interquartile range {IQR}] age 10 years 2 months [6 years 3 months–14 years 1 month]), 47 with NMDs (such as spinal muscular atrophy and Duchenne muscular dystrophy) and 26 with CNS disorders (such as cerebral palsy, encephalitis, neurometabolic and other diseases). The median (IQR) VAS score for the perceived benefit of MI‐E therapy at stable state and respiratory tract infection were 9 (6–10) and 10 (8.5–10) respectively. Sixty‐two per cent were reluctant or unwilling to pause MI‐E therapy, with no NMD versus CNS disorder group difference. After MI‐E initiation, fewer physician consultations and hospitalizations were reported by the group with NMDs. The MI‐E routine was similar in both groups. The mean (SD) HRQoL score for 26 of 51 eligible children was 71 (16.7). Interpretation: MI‐E treatment was generally perceived as beneficial and performed equally in both diagnostic groups. HRQoL was in line with children with a moderate‐to‐severe chronic condition. What this paper adds: Mechanical insufflation‐exsufflation (MI‐E) was generally perceived as beneficial by the children and parents.The reported benefit of MI‐E was higher among daily than sporadic MI‐E users.The MI‐E treatment routine did not differ between diagnostic groups.The health‐related quality of life in this neuropaediatric population was in line with that of children with other moderate‐to‐severe chronic conditions. [ABSTRACT FROM AUTHOR]

Aim: To determine the prevalence of long‐term mechanical insufflation‐exsufflation (MI‐E) and concomitant mechanical ventilation in children with neurological conditions, with reported reasons behind the initiation of treatment. Method: This was a population‐based, cross‐sectional study using Norwegian national registries and a questionnaire. Results: In total, 114 of 19 264 children with a neurological condition had an MI‐E device. Seventy‐three of 103 eligible children (31 females, 42 males), median (min–max) age of 10 years 1 month (1y 5mo–17y 10mo), reported their MI‐E treatment initiation. Overall, 76% reported airway clearance as the main reason to start long‐term MI‐E. 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‐E use was reported in 34% and 7% of children, of whom 83% and 57% respectively received ventilator support. One‐third of the MI‐E 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‐term MI‐E users was 56%. Interpretation: The prevalence of MI‐E in a neuropaediatric population was 6 per 1000, with two‐thirds having NMDs and one‐third having conditions of the CNS. The decision to initiate MI‐E in children with neurological conditions relies on clinical judgment. What this paper adds: The prevalence and age at initiation of mechanical insufflation/exsufflation (MI‐E) differed between diagnoses.MI‐E was most commonly used in spinal muscular atrophy, where it generally coincided with ventilatory support.One‐third of MI‐E devices were given to children with central nervous system conditions, and one‐third also received ventilatory support. What this paper adds: The prevalence and age at initiation of mechanical insufflation/exsufflation (MI‐E) differed between diagnoses.MI‐E was most commonly used in spinal muscular atrophy, where it generally coincided with ventilatory support.One‐third of MI‐E devices were given to children with central nervous system conditions, and one‐third also received ventilatory support. This article is commented on by Langdon and Cooper on pages 494–495 of this issue. [ABSTRACT FROM AUTHOR]

Background Allergic sensitization is frequently present in asthma and rhinitis, but the role of specific immunoglobulin E (s-IgE) is not always clear. Multiple s-IgE analyses may provide insight into this relationship, thus a microarray chip was developed within the EU-funded Me DALL project. The main objective was to evaluate the performance of the Me DALL-chip compared to Immuno CAP and skin prick test ( SPT) in detecting allergic sensitization in children and secondarily to investigate the association to asthma and allergic rhinitis. Methods From the 'Environment and Childhood Asthma Study', 265 children were investigated at 10 and 16 yr of age with clinical examination, interview, SPT, Immuno CAP, and the Me DALL-chip including 152 allergen components in the analysis. Results Allergic sensitization at 10 yr was more frequently detected using the Me DALL-chip (38.1%) compared to the Immuno CAP (32.8%) (p = 0.034) and SPT (25.5%) (p < 0.001), but no significant difference was seen at 16 yr (Me DALL-chip 49.8%, Immuno CAP 48.6%, SPT 45.8%). The Me DALL-chip did not differ significantly from the Immuno CAP or SPT in terms of detecting allergic sensitization in subjects with rhinitis or asthma at 10 or 16 yr. Conclusion The prevalence of allergic sensitization increased by all three diagnostic tests from 10 to 16 yr was similar by SPT and Immuno CAP and significantly higher with the Me DALL-chip at 10 yr. All three tests were comparable for identification of allergic sensitization among children with current rhinitis or asthma. [ABSTRACT FROM AUTHOR]

Background Childhood asthma frequently has allergic comorbidities. However, there is limited knowledge of the longitudinal development of asthma comorbidites and their association to bronchial hyper-responsiveness ( BHR) and airway inflammation markers. We therefore aimed to assess the association between childhood asthma with allergic comorbidities and BHR and fractional exhaled nitric oxide ( FENO) and the impact of gender on these associations. Methods Based on data from 550 adolescents in the prospective birth cohort 'Environment and Childhood Asthma' study, asthma was defined for the three time periods 0-2, 2-10 and 10-16 years of age, using recurrent bronchial obstruction ( rBO) 0-2 years of age as a proxy for early asthma. Asthma comorbidities included atopic dermatitis (AD) and allergic rhinitis (AR) from 10 to 16 years. At age 16 years BHR, assessed by metacholine bronchial challenge, and airway inflammation, assessed by FENO, were compared between the groups of asthma with or without the two comorbidities, to a reference group with no never asthma, and subsequently stratified by gender. Results Boys with asthma and AR, regardless of AD had significantly more severe BHR and higher FENO than the other asthma phenotypes. Almost half of the children remained in the asthma and AR category from 10 to 16 years, the entire difference being determined by new incident cases from 10 to 16 years. Conclusions Asthma phenotypes characterized by allergic comorbidities and AR in particular appears closely associated with BHR and FENO, especially among boys. [ABSTRACT FROM AUTHOR]