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Neuromuscular hypoventilation — RACP Paediatrics MCQ

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HardRespiratoryNeuromuscular hypoventilationRACP Paediatrics

A 6-year-old with neuromuscular disease and nocturnal hypoventilation has a rising pCO2 on overnight oximetry. Spirometry shows a restrictive pattern with FVC 40% predicted. What is the most appropriate respiratory support?

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Correct answer: C — BiPAP

BiPAP (bilevel positive airway pressure) is indicated for children with neuromuscular disease and nocturnal hypoventilation (rising CO2). It provides both inspiratory and expiratory pressure support. Long-term NIV improves quality of life and survival. Cough augmentation techniques (assisted cough, mechanical insufflation-exsufflation) should also be incorporated.

Reference: RCH Melbourne – 2023 – Neuromuscular Disease Respiratory CPG; RACP Paediatric Curriculum – Respiratory