Airway maintenance (management) for surgery in children with a recent history of upper respiratory tract infection: a systematic review of randomized clinical trials

Abstract

Anesthesiologists often encounter children presenting with signs and symptoms of upper respiratory tract infection (URTI). During this, there is release of various inflammatory and immune mediators, such as bradykinin, histamine and leukotrienes, which may be associated with bronchoconstriction. These mediators and neuropeptides determine contraction of airway smooth muscle by direct effects on the bronchial muscles and potentiation of cholinergic neurotransmission. Studies involving pediatric patients show that there is a direct correlation between URTI and the increased incidence of respiratory adverse events (RAE) in the perioperative period, which are characterized by: coughing, laryngospasm, bronchospasm, desaturation, atelectasis, pneumonia, apnea, and even death. The laryngeal mask (LM) is a supraglottic device for airway access, for the ventilation, standing between the face mask (MF) and the tracheal tube (TT), both in terms of anatomic location as in degree of invasion the airway. The work will consist of a systematic review, in accordance with the recommendations of the Cochrane qualitatively and quantitatively using meta-analysis where possible. The primary outcomes will be considered adverse respiratory events: cough, bronchospasm, laryngospasm, desaturation, atelectasis, pneumonia and death. Secondary outcomes will need to replace the maintenance of airway during surgery, unplanned hospital admission, need for ICU admission, length of hospitalization device.