Required Reconsideration of Periprocedural Resuscitation Status: Can Ethics Principles Inform Institutional Practice?

National guidelines recommend the opportunity to reconsider existing Do-Not-Resuscitate (DNR) orders periprocedurally rather than automatic suspension of DNR orders. We retrospectively reviewed records for oncology patients with active DNR orders presenting for anesthesia between 2023 and 2025. Twenty patients (mean age 12 years; 60% male) underwent 41 procedures: radiation (43%), imaging (22%), interventional radiology (20%), and surgery (15%). DNR orders were suspended in 85.3% of procedures and maintained in 14.7%. No significant association existed between procedure type and DNR status (p = 0.4). No cardiopulmonary arrest events occurred. Documentation of communication regarding DNR reconsideration occurred in one perioperative encounter. Findings highlight clinical opportunities to improve periprocedural communication processes.