Gastroesophageal reflux in neurologically impaired children: perioperative evaluation and management.

Gastroesophageal reflux and malnutrition are major determinants of perioperative morbidity and mortality in neurologically impaired children. The incidence of these risk factors can be reduced through careful preoperative evaluation and nutritional rehabilitation combined with the use of perioperative techniques intended to control the acid aspiration syndrome. In this article, we outline our approach to the preoperative and intraoperative management of the neurologically impaired child.