Multidisciplinary Development and Evaluation of Pre-anesthesia Assessment Guidelines for Pediatric Obese Patients |Biomedgrid

Background: Obesity may increase the risk of anesthetic complications. Obesity and related comorbidities may not be recognized until presurgical evaluation. Aim: We describe a multidisciplinary effort resulting in the evaluation of outcomes post implementation of guidelines for evaluation of obese children in the pre-anesthesia assessment (PASS) clinic and its impact on anesthetic complications. Methods: Literature review and expert consensus were used to create evidence-based guidelines for pre-operative assessment of obese children in this quality improvement project. Representatives from anesthesia, cardiology, endocrinology, pulmonary and surgery were involved. Outcomes related to guideline implementation were compared pre-post 1year implementation and stratified by presence/absence of PASS evaluation. Subjects included ambulatory surgery patients 2-18 years of age, with a BMI> 95. Outcome measures include: 1) intra-operative desaturation, 2) difficulty during ventilation, and 3) escalation of care.