Upper Respiratory Infections

Most adults will suffer 1 URI per year; this incidence jumps to approximately 6 episodes per year in the pediatric population. Approximately 95% of the infections have a viral etiology.

URIs are generally self-limiting; however, airway hyperreactivity may persist for several wk.

Adults are less likely to have URIs due to larger airways enabling them to compensate with edema and increased secretions.

Those with underlying disease, especially diseases afflicting the airways, are more likely to have complications following anesthesia when confounded with URI.

Complications include laryngospasm, bronchospasm, atelectasis, coughing, airway obstruction, hypoxia, stridor, and breath holding.

A pt with a fever, purulent rhinitis, or productive cough should have elective surgery canceled.

Lung-specific: Bronchospasm, desaturation, apnea, and atelectasis

Cancelation of surgery and prolonged hospital stay

To cancel or not to cancel has been the dilemma of many anesthesiologists when confronted with a pt scheduled for elective surgery who has recently had or currently has an URI.

Several studies have linked URIs to possible morbidity; however, none have linked them to increased mortality.

Retrospective studies: Children with a recent URI were at higher risk for laryngospasm, bronchospasm, and stridor. Such children had a 2–7 times greater incidence of resp complications. The complication risk increased to 11-fold if the trachea was intubated.

Prospective studies: Children who developed laryngospasm were twice as likely to have a URI.