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Anesthesia for Pediatric Patients with Common Comorbidities Part III
Book chapter

Anesthesia for Pediatric Patients with Common Comorbidities Part III

Nathalie Peiris and Pravin Taneja
Pediatric Anesthesia: A Guide for the Non-Pediatric Anesthesia Provider Part II
May 2022
DOI: https://doi.org/10.2174/9789815036213122010006

Abstract

Diabetes type 1 Diabetes type 2 Continuous glucose monitoring Hyperglycemia Apnea Insulin pumps Pulmonary vascular resistance Leukemias Fontan Systemic vascular resistance Obesity Ex-premature Low birth weight Right-to-left Cardiotoxicity Hypoglycemia Insulin Congenital heart defects Chemotherapy Prematurity Respiratory distress syndrome Left-to-right Bronchopulmonary dysplasia Lymphomas Media-stinal mass
There have been dramatic improvements in the survival of neonates andchildren with many diseases and disorders due to advancements in medicine over thepast several decades. These advances are attributed to the better understanding of thesedisease processes, the advent of multidrug combinations, molecularly targetedtherapies, critical care and various surgical interventions. In the wake of this rapidlydeveloping wide range of treatment protocols, the anesthesiologist needs to have a clearunderstanding of these disorders and their comorbidities, and stay abreast of the varioustreatment modalities, including their safety and toxicity profiles. This review attemptsto emphasize some of the clinical conditions unique to these patients and specialconsiderations for the conduct of anesthesia in this population.Some of the disease processes and comorbidities discussed here include anestheticconsiderations for ex-premature infants, diabetes mellitus, obesity, childhood cancer,and children with congenital heart disease who present for non-cardiac surgery. Theobjective of this discussion is to provide an updated and comprehensive review ofcurrent perioperative anesthetic management of pediatric patients with theseconditions. We also delineate the effects of anesthesia during the perioperative course,including major metabolic changes that may result in increased morbidity. We provideguidelines for any anesthesia provider involved in the care of these vulnerable patients.Special considerations need to be taken to promote the physical and mental wellbeingof these children and their families. Collaborative coordination with all providersinvolved in care is essential to provide safe and effective anesthesia to this subset ofpatients.

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