Pulmonary and Ear-Nose-Throat Considerations in the Perioperative Period for Children with Medical Complexity.

Children with medical complexity (CMC) represent a unique and growing population with multidisciplinary needs that require comprehensive management. CMC often require surgical procedures that need careful planning. They have variable baseline respiratory needs, including noninvasive ventilation, invasive mechanical ventilation, or tracheostomies. Additionally, they may have multiple coexistent conditions such as asthma or airway reactivity, oropharyngeal dysphagia, excessive oral secretions, aspiration, sleep-disordered breathing, and difficult airway scenarios. A thorough assessment by the Pulmonologist, Otolaryngologist, and Anesthesiologist of the underlying risk factors, along with pulmonary and airway optimization, is essential in preparing for surgical procedures to reduce the risk of postoperative complications.