Frequently we get calls from a patient’s parent that their child who is going to undergo elective surgery has an upper respiratory infection (URI), and we are then asked whether the surgery should be postponed. While the decision to proceed with surgery rests with the surgeon and the anesthesiologist, the initial inquiry to determine if elective surgery should be canceled can often start with a call to the primary care pediatrician’s office. Thus for all parties involved, including the family, it would be good to know the data about whether having had a recent or current cold could result in an airway-related adverse event or a need for additional airway interventions during the surgery or post-operatively. Fortunately, this week Mallory et al. (10.1542/peds.2017-0009) share with us an analysis of 83,000-plus children who comprise the Pediatric Sedation Research Consortium database.
The authors looked at complications of having URI symptoms around the time of surgery while controlling for things like anesthetic used and type of surgical procedure performed. The authors then note differences in airway-related adverse events (AAE) in the setting of having or not having a URI. While the bad news is that there is an increased frequency of adverse events in children with current URIs, especially with those involving thick secretions, the good news is that even in this circumstance, the rates of adverse events and need for an airway intervention are low. So what does this mean for our patients? The authors will keep you wide-awake with their discussion of the findings and their takeaways from this study as to when elective surgery with URI symptoms is indicated and when it is s-not. Be in the nose, we mean in the know, and read this study to learn more.