Person: Monsalve Rosales, Macarena Carolina
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Monsalve Rosales
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Macarena Carolina
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Publication Paciente pediátrico con infección respiratoria alta y cirugía electiva(2022) Macarena Gilbert C; Monsalve Rosales, Macarena CarolinaA significant number of children presenting for surgery will arrive with an upper respiratory infection (URI). As a result of this infection, the airway may remain hyperreactive to stimuli for up to 6 weeks. Patients who require anesthesia during active URI or during the 6 weeks post active infection are at increased risk of perioperative respiratory complications, such as cough, post-intubation croup, desaturation, atelectasis, pneumonia, laryngospasm, and bronchospasm. These complications, although mostly of routine management, can precipitate more serious episodes that require an extension of hospital stay, hospitalization in intensive care units, respiratory arrest, and even death. For this reason, it is extremely important to analyze the risk of presenting an adverse respiratory event and the need to defer scheduled surgery. This decision can be associated with significant costs for the patient and the family, and can place a great burden on health systems and should be made as objectively as possible, seeking to balance risks and benefits. Along with the identification of risk factors for patients, surgeries and anesthesia, we show the COLDS scale, designed to determine respiratory risks in the perioperative period. The use of this scale might generate valuable information for joint decision-making between parents and physicians. Considering the frequency with which we are faced with children with URI, we briefly review the management of laryngospasm and bronchospasm, as well as certain aspects concerning the status of COVID-19, the need for surgery and pediatric patients.