Sunday, October 18, 2009

Perioperative Evaluation, Assessment and Treatment in Pediatrics

The Cleveland Clinic Children's Hospital offers 4 hours CME courses (AMA category 1) every month. Yesterday, October 17, 2009, I presented at 9AM a lecture on Perioperative Assessment, Evaluation and Treatment in Pediatrics. (

What is unique about my presentation is that perioperative medicine as a separate field is way underdeveloped in Pediatrics. In adult medicine, especifically, in Hospital Medicine, the role of the hospitalist as an expert in Perioperative Medicine has been blossoming and growing up year by year, and is now a well established subspecialty field.

Perioperative Medicine is a discipline that provides a well rounded evaluation to the patient undergoing surgery, and has the objective of identifying and stabilizing in a timely fashion all the potential comorbidities, risk factors as well as potential complications that a patient can have during surgery.

In the perioperative evaluation for non-cardiac surgery, there are well developed guidelines for assessment and prevention of postoperative cardiovascular and pulmonary complications. For example, the 2007 AHA guidelines ( and the 2009 ESC guidelines ( or the ACP perioperative pulmonary guidelines ( or AHA guidelines for perioperative assessment of the morbid obese patient ( Other well established guidelines are about perioperative management of antithrombotic therapy ( and prevention of venous thromboembolism (

However, there are no real guidelines or well delineated consensus or statements for perioerative management in children. There are well written articles that focuses on specific aspects or specific diseases (congenital heart surgery, diabetes, sickle cell anemia, etc.) but there is a lack of a guideline that delineates general rules in perioperative management of the Pediatric Patient.

In the lecture, I provide an outline that focus on the general approach to the perioperative management of the pediatric patient, and then on specific issues focused mostly on the children with complex medical problems.

I hope this effort offers a broad perspective of the important aspects to take into consideration in the perioperative evaluation and management of the pediatric patient.

As always, primum non nocere.

Follow me on Twitter for daily up-to-date cutting edge medical information!

Follow medpedshosp on Twitter


My Blog List

My slides at Scribd

You can access the the presentations I have given at the Department of Hospital Medicine as well as the Children's Hospital at the Cleveland Clinic, as well as lectures given to the medical students at the Cleveland Clinic Lerner College of Medicine.

Slideshows by User: mauron

Initiative to decrease Healthcare-Associated Infections


This site express the opinion of the author and not of his employer.

The objective of this blog is to provide updated medical education in Internal Medicine and Pediatrics, with emphasis in controversies or current information in Hospital Medicine.

The information provided in this blog is intended for healthcare professionals only.

All non-healthcare professionals visitors should consult with their physician any specific health questions, and discuss any information provided through this site with their physician before taking any action with regards to their healthcare needs. The information in this blog is NOT intended to provide medical advice.

This blog provides links to websites, including medical journals, medical news feeds, health-care related blogs, etc. These links do not constitute an endorsement of their products, policies, statements or actions.

The author of this blog encourages a critical review of literature and encourage the direct access of peer-reviewed medical journals as primary source of medical information.

Most information provided will be related to direct source data (updated guidelines, medical societies statements, etc.); however the utility of clinical cases as a source of medical education is recognized and therefore interesting and high-yield educational value clinical cases may be used. All clinical cases used will be compliant with patient privacy according with the HIPPA legislation act. (http://www/

By accessing this blog, the visitors acknowledge there is no physician-patient relationship between them and the author.


- This site is hosted free of charge by Blogger.

- This blog does not host or receive funding from advertisement.

- No comments posted on this blog have the right of posting advertisement of any kind. This blog is strictly academic.


No information is collected from any visitor to this blog. The purpose of this blog is strictly educational. The email address of whomever contact the author of this blog is kept strictly confidential and is not passed to any third party unless required by law.


Only registered users and followers of this blog can leave comments.

New comments are moderated. No profanity or politically incorrect statements are allowed. No comments intending to offend any culture, race, country, religion or political beliefs will be permitted.

This is an exclusively medically academic blog with the only intent of provoking thought (intellectual stimulation) and increase medical knowledge. Comments should be merely academic and neutral in political beliefs.