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There is a lack of standardization regarding peri\u2010operative stress\u2010dose glucocorticoids in paediatric clinical practice with the absence of agreed protocols. For the individual patient, the risk of adrenal crisis must be weighed against the potential adverse clinical outcomes associated with unnecessary or supra\u2010physiologic glucocorticoid dosing in susceptible patients. Specific clinical concerns in the paediatric population include osteopenia, growth restriction and increased risk of cardiovascular disease in adulthood. This review aimed to identify and evaluate available literature in the field of peri\u2010operative stress\u2010dose glucocorticoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive literature search was conducted to construct a narrative review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The outcome of this review identified that paediatric patients, unlike adults, do not show a graded response to surgical stress with implications for glucocorticoid stress dose regimens for general anaesthesia and less invasive surgical procedures. The studies highlight a lack of information on physiological steroid responses to stress situations and differences in the approach to glucocorticoid replacement strategies in the paediatric population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The review identified there is a lack of high\u2010quality paediatric\u2010specific studies evaluating appropriate stress\u2010dose glucocorticoid regimens in paediatric patients with or at risk of adrenal insufficiency. Further research is needed to establish clear evidence\u2010based clinical guidelines for paediatric peri\u2010operative practice regarding steroid stress dosing in adrenal insufficiency. Current knowledge would suggest that a balanced view of risks and benefits should be taken appropriate to the clinical context, to dictate peri\u2010operative stress\u2010dose glucocorticoids use that permits safe perioperative management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13952","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T10:54:12Z","timestamp":1626346452000},"page":"1187-1194","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Peri\u2010operative steroid management in the paediatric population"],"prefix":"10.1111","volume":"65","author":[{"given":"Chloe","family":"Heath","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain Management Perth Children\u2019s Hospital Perth Western Australia 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