The pediatric patient and upper respiratory infections

Area of Science:

• Pediatric Anesthesiology
• Respiratory Medicine
• Surgical Risk Assessment

Background:

• Children often require elective surgery with active or recent upper respiratory infections (URIs).
• Increased respiratory adverse events are noted in this patient population.
• Current thresholds for surgical cancellation due to URIs lack clinical consistency.

Purpose of the Study:

• To review factors influencing decisions to proceed with or cancel elective surgery in children with URIs.
• To identify areas where more data are needed regarding surgical risks and management strategies.
• To explore potential therapies for reducing adverse events in this setting.

Main Methods:

• Literature review and clinical consensus discussion on risk factors.
• Analysis of variables such as respiratory secretions, pulmonary disease, intubation needs, and surgical site.
• Identification of knowledge gaps concerning perioperative outcomes.

Main Results:

• Surgical cancellation decisions are influenced by URI severity, patient comorbidities, airway management needs, and surgical location.
• Significant variability exists among clinicians regarding acceptable risk thresholds.
• Limited data exist on the precise risks of proceeding with surgery and the efficacy of interventions.

Conclusions:

• Standardized guidelines are needed for managing pediatric elective surgery in the context of URIs.
• Further research is crucial to quantify risks and evaluate therapies like lidocaine for managing laryngospasm in affected children.