Perioperative Management in Infants and Children

Abstract

Pediatric patients will arrive and require some level of evaluation and treatment regardless of whether they receive definitive care or are transferred. The basic priorities of initial resuscitation remain the same: Airway, breathing, and circulation. Attention to these priorities and early stabilization will lead to better overall outcomes if proper steps are taken when the child is first seen and not delayed until after transfer to a referral hospital. Signs that an infant has respiratory distress can be subtle but demand the administration of supplemental oxygen and transfer to a higher level of care. Emergence from anesthesia may be unpredictable because of the larger proportion of cardiac output that goes to the infant brain, the relative immaturity of the blood–brain barrier, differences in volumes of distribution for inhalational anesthetics, and different uptake in fat stores in the infant body.