Upper respiratory infections are common in children. Apart from acute URI symptoms, all of the following are associated with an increased risk of pulmonary complications EXCEPT:
A. Age less than 3 years
B. History of prematurity
C. Parental smoking
D. History of congenital heart disease presenting for cardiac surgery
The answer is A. The risk factor is LESS THAN 1 YEAR, not less than 3 years. A correct answer, but the wrong age. The average toddler has 6 – 10 URIs each year. Pulmonary complications associated with a preceding or current URI include laryngospasm , bronchospasm, hypoxia, severe coughing and airway obstruction. Risk factors for these pulmonary complications include age < 1 year, history of prematurity, asthma, parental smoking, and children with congenital heart disease presenting for cardiac surgery. Other considerations that may preclude going ahead with an otherwise elective case include patients with fever ≥ 38.5 ° C, purulent nasal discharge, productive cough, lower respiratory tract signs, or chronic pulmonary disease (cystic fibrosis, bronchopulmonary dysplasia, asthma) or any signs of systemic toxicity. The type of surgery (particularly airway or ENT surgery) and method of airway management may increase these risks. Bronchial reactivity remains for up to 6 weeks after an URI. However, the majority of the risk is lowered after 2 weeks.