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

Regli, Adriana,b,c; Becke, Karind; von Ungern-Sternberg, Britta S.e,f

Current Opinion in Anesthesiology: June 2017 - Volume 30 - Issue 3 - p 362–367
doi: 10.1097/ACO.0000000000000460
PEDIATRIC ANESTHESIA: Edited by Lynne R. Ferrari

Purpose of review This review summarizes the current evidence for the management of children with recent upper respiratory tract infections (URTIs). Furthermore, the review includes management guidelines for children with URTIs.

Recent findings Good history and clinical examination is sufficient in most children presenting with URTI. Testing for immune markers or preoperative nitric oxide measurement does not add any additional value. Preoperative bronchodilator administration, intravenous induction with propofol, and noninvasive airway management all reduce the occurrence of respiratory adverse events.

Summary Most children can be safely anaesthetized even in the presence of an URTIs if the perioperative anaesthesia management is optimized. In this review article, we have included a management algorithm for children with URTI presenting for elective surgery.

aDepartment 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

Correspondence to Professor Britta S. von Ungern-Sternberg, Chair of Pediatric Anesthesia, Department of Anesthesia and Pain Management, Princess Margaret Hospital for Children, Roberts Road, Subiaco, WA 6008, Australia. Tel: +61 8 9340 8109; e-mail: Britta.regli-vonungern@health.wa.gov.au

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