Children with respiratory complexities and paediatric palliative care

Managing respiratory diseases using a palliative care lens can be challenging. Palliative care is a specialty service dealing with sick, life-threatening conditions and terminally ill children using a multi-disciplinary team to reach similar goals of care. The trajectory of respiratory diseases in children is often unpredictable. The basis of management may focus on understanding the disease pathophysiology, a non-medical approach, or medical management. Families and patients can be supported by managing their expectations, achieving realistic goals, and applying available resources locally. There are local guidelines available to guide the appropriate intervention, such as the use of NIV for specific groups of patients, however, this may not be feasible due to the financial constraints and unavailability of local respirologists specializing in the care of rare respiratory conditions. A holistic approach must consider not only medical and physical therapy, but also engaging in other aspects such as psychosocial, emotional, and spiritual for both the patients, according to their developmental understanding, and their families.