Why Colds Are Uncool for Anesthesia

Did you know that a mild respiratory infection could be the culprit of an adverse respiratory event during a patient undergoing anesthesia? Dr. Pedro Solorzano and Dr. Ana Mavarez join Krishna Shah to discuss the evaluation and management of upper respiratory infections for patients undergoing anesthetic care. Specifically, they will:  

• Recall key aspects of the preoperative assessment performed by the pediatric anesthesiologist prior to perform an anesthetic.  
• Understand why an upper respiratory infection (URI) affects the pediatric anesthesiologist’s decision to proceed or postpone a surgery or procedure requiring anesthesia or sedation.  
• Identify the severity of the URI symptoms that would increase the likelihood of perioperative respiratory adverse events (PRAE).  
• Understand the anesthetic management of a patient with an URI to minimize the risk of PRAE requiring emergent anesthesia and the timing to postpone it if the surgery is elective. 
• Initiate interventions to optimize the pediatric patient’s respiratory status with URI prior to receiving anesthesia.  

FREE CME Credit (requires free sign-up): https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11410 

References: 

1. Davis, Peter J. and Cladis, Franklyn, "Smith's Anesthesia for Infants and Children. 9th ed. (2017). Chapter 45. Respiratory disorders. Page 1127-1128.
2. Von Ungern-Sternberg BS, Boda K, Chambers NA, Rebmann C, Johnson C, Sly PD, Habre W. Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study. Lancet. 2010 Sep 4;376(9743):773-83. doi: 10.1016/S0140-6736(10)61193-2. PMID: 20816545.
3. Regli A, Becke K, von Ungern-Sternberg BS. An update on the perioperative management of children with upper respiratory tract infections. Curr Opin Anaesthesiol. 2017 Jun;30(3):362-367. doi: 10.1097/ACO.0000000000000460. PMID: 28291127.
4. Cote C, Lerman J amd Anderson B, A Practice of Anesthesia for Infants and Children. 6th ed. (2019). Chapter 13. Essentials of pulmonology. Page 285-286.
5. Houck, P. Anesthesia for the child with a recent upper respiratory infection. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA