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An update on the perioperative management of children with upper respiratory tract infections

Adrian Regli1, Karin Becke, Britta S von Ungern-Sternberg

  • 1aDepartment of Intensive Care, Fiona Stanley Hospital, Murdoch bSchool of Medicine and Pharmacology, The University of Western Australia cSchool of Medicine, The University of Notre Dame, Perth, Western Australia, Australia dDepartment of Anesthesia and Intensive Care, Klinik Hallerwiese, Cnopf'sche Kinderklinik, Nuernberg, Germany eDepartment of Anesthesia and Pain Management, Princess Margaret Hospital for Children, Subiaco fSchool of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.

Current Opinion in Anaesthesiology
|March 15, 2017
PubMed

Insights

Children with recent upper respiratory tract infections (URTIs) can undergo anesthesia safely with optimized perioperative management. This review provides evidence-based guidelines and a management algorithm for pediatric URTI cases.

Area of Science:

  • Pediatric Anesthesiology
  • Respiratory Medicine
  • Critical Care

Background:

  • Upper respiratory tract infections (URTIs) are common in children and pose challenges for perioperative management.
  • Optimizing anesthetic care is crucial for minimizing respiratory adverse events in pediatric patients with URTIs.

Purpose of the Study:

  • To review current evidence on managing children with recent URTIs.
  • To provide evidence-based management guidelines for pediatric URTIs.

Main Methods:

  • Comprehensive literature review of studies on URTI management in children undergoing anesthesia.
  • Synthesis of evidence to formulate management recommendations and an algorithm.

Main Results:

  • A thorough medical history and physical examination are often sufficient for URTI assessment.
  • Immune marker testing and preoperative nitric oxide measurements do not enhance clinical value.
  • Preoperative bronchodilator use, propofol for induction, and noninvasive airway management reduce respiratory complications.

Conclusions:

  • Pediatric patients with URTIs can generally be safely anesthetized with optimized perioperative strategies.
  • The review presents a practical management algorithm for elective surgical cases involving children with URTIs.
Abstract

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