Perioperative care of children with a metabolic disease

Veyckemans, Francis [UCL] Scholtes, Jean-Louis [UCL]

The perianesthetic care of the child with a metabolic disorder is a stressful experience for the child’s family and at least a pharmacologic challenge for the anesthesiologist. A careful team approach is necessary to plan each aspect of anesthetic care. Moreover, mild forms of metabolic disorders can present as unexplained perioperative events: the anesthesiologist should keep the diagnosis of previous undiagnosed metabolic disorder in its diagnostic approach to these problems. This chapter proposes a frame to help the anesthesiologist establishing an anesthetic plan adapted to the child’s known or suspected pathology and its current preoperative status and highlights the importance of developing a “metabolic reflex” when a child presents with an unusual clinical picture in the perioperative period