Update on the anesthetic management of the pediatric patient with upper airway infection.

Abstract

The high incidence of upper respiratory tract infections (URTI) in childhood means that a significant percentage of pediatric patients presenting for elective surgery present symptoms of IVAs at that time or in the previous weeks. Receiving general anesthesia under this condition implies an increased risk for the appearance of perioperative  respiratory adverse events (PRAE), which also lasts up to six weeks after having suffered a URTI due to the persistence of hyperreactivity in the airway. Despite the fact that most of the complications are mild and easy to manage, sometimes serious clinical entities can arise that increase morbidity and mortality and generate an increase in health care costs due to prolonged hospital stays and the need to apply additional resources.

The purpose of this review is to present an updated summary of the current evidence about the risk factors and mechanisms that lead to the appearance of PRAE in pediatric patients presenting with URTI at the time of elective surgery, as well as the different strategies for its anesthetic management in the different phases of the anesthetic-surgical process. This is key to selecting those cases in which delaying surgical intervention will be of clear benefit, fundamentally for the patient, but also for the better functioning of the health system.