title: Anesthesia in children with a cold.
abstract: OBJECTIVE
  Common colds are infections of mostly viral origin that frequently occur in childhood. The overall anesthetic risk in children with respiratory tract infections is increased because of the increased incidence of perioperative respiratory adverse events (PRAEs). Although the morbidity and mortality of PRAE are low when managed by experienced anesthesiologists, careful preoperative assessment and perioperative anesthetic care are indispensable.
  
  
  RESULTS
  This review summarizes recent studies to give a brief overview and background information with regard to the pathophysiological mechanisms of upper respiratory tract infections, risk factors for PRAE in children with a cold, management of anesthesia and prevention and treatment of frequently observed adverse events as well as a proposal for a decision algorithm.
  
  
  CONCLUSIONS
  Children with a cold can be safely anesthetized under certain circumstances; however, anesthesia in children with symptomatic infections with wheezing, purulent secretion, fever and reduced general condition should be postponed for at least 2 weeks. Anesthetic treatment options for children with infection of the upper airway with a runny nose and cough include preoperative inhalational therapy with salbutamol, avoidance of endotracheal intubation whenever possible, use of a face mask or laryngeal mask, intravenous induction with propofol and avoidance of desflurane. Prevention, early recognition and immediate treatment of complications by an experienced anesthesiologist are crucial.
authors.affiliation: Department for Anesthesiology and Intensive Care Medicine, Cnopf Children's Hospital, Hospital Hallerwiese, St. Johannis-Muehlgasse, Nuernberg, Germany. Karin.Becke@diakonieneuendettelsau.de
authors.forename: Karin
authors.initials: K
authors.lastname: Becke
mesh_terms: D058109:Airway Management; D000465:Algorithms; D000758:Anesthesia / Q000009:adverse effects; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D003139:Common Cold / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017214:Laryngeal Masks; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011300:Preoperative Care; D018357:Respiratory Syncytial Virus Infections; D012137:Respiratory System / Q000503:physiopathology; D012307:Risk Factors