Reactive Airways Disease

Acute wheezing indicates small airways narrowing, which is typically due to inflammation, edema, and mucus inspisation, with or without infection.  The effects are greater in smaller children; 4-6 weeks is the time course for inflammation to resolve.  Unless circumstances demand otherwise, surgery is postponed until that time period is past; consult the anesthesiologist.   Follow up is dependent upon the severity of disease:

MILD   Symptoms are infrequent, easily controlled by prn inhaler or nebulizer, no h/o hospitalization, and ER visits are rare.

MODERATE   A child taking daily medication, or who requires more than 1 drug to control symptoms when they occur, or who has regular ER visits or hospitalizations, should  have medications given preoperatively. Systemic steroids may be utililized preventatively, and need not be followed up. If control is poor, or there is an acute exacerbation, he will need evaluation for additional treatment.