Strategies to Maintain Homeostasis in Major-Risk Pediatric Surgery

The appropriate definition of the term “perioperative risk” is still debated, mostly as far as the pediatric field is concerned. Since the 1950s, many reports have been published on the statistical data regarding pediatric perioperative mortality, aiming to establish standard criteria on which mortality, surely related to the anesthesia, could be based and to compare data from different sources. None of these studies has achieved the purpose, mostly due to the presence of several variables: 1) age of the patient; 2) ASA group; 3) type of disease to be treated; 4) type of surgical treatment; 5) concomitant diseases; 6) emergency or elective surgery; 7) standard of perioperative care available.