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Children 2018, 5(9), 126; https://doi.org/10.3390/children5090126

Multidisciplinary Perioperative Care for Children with Neuromuscular Disorders

1
Monroe Carell, Jr Children’s Hospital at Vanderbilt, Nashville, TN 37232, USA
2
Vanderbilt University Medical Center, Nashville, TN 37232, USA
*
Author to whom correspondence should be addressed.
Received: 1 August 2018 / Accepted: 7 September 2018 / Published: 12 September 2018
(This article belongs to the Section Pediatric Surgery)
Full-Text   |   PDF [707 KB, uploaded 12 September 2018]   |  

Abstract

Children with neuromuscular diseases present unique challenges to providing safe and appropriate perioperative care. Given the spectrum of disease etiologies and manifestations, this is a population that often requires specialized multidisciplinary care from pediatricians, geneticists, neurologists, dieticians, and pulmonologists which must also be coordinated with surgeons and anesthesiologists when these patients present for surgery. Several of these diseases also have specific pharmacologic implications for anesthesia, most notably mitochondrial disease and muscular dystrophies, which put them at additional risk during the perioperative period particularly in patients presenting without a formal diagnosis. Techniques and strategies to fully evaluate and optimize these patients preoperatively, manage them safely intraoperatively, and return them to their baseline status postoperative are particularly important in this vulnerable group of patients. Utilizing a review of inherited neuromuscular conditions, generalized perioperative concerns, and specific complications related to anesthesia, this article provides an overview of pertinent considerations and recommends a framework for management of these patients. View Full-Text
Keywords: neuromuscular disorder; mitochondrial disease; muscular dystrophy; rhabdomyolysis; malignant hyperthermia; anesthesia; perioperative care neuromuscular disorder; mitochondrial disease; muscular dystrophy; rhabdomyolysis; malignant hyperthermia; anesthesia; perioperative care
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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MDPI and ACS Style

Kynes, J.M.; Blakely, M.; Furman, K.; Burnette, W.B.; Modes, K.B. Multidisciplinary Perioperative Care for Children with Neuromuscular Disorders. Children 2018, 5, 126.

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