Purpose: Neurologically impaired patients often experience complex challenges in respiratory and nutritional management that may necessitate surgical intervention. Furthermore, some patients admitted to specialized facilities for neurologically impaired individuals do not receive adequate postoperative follow-up after being transferred. Kurume University Hospital has established a system of continuous routine rounds at such facilities. This review aims to describe the rationale, methods, and outcomes of multidisciplinary bedside support, with particular emphasis on nutritional evaluation, swallowing function assessment, and gastrointestinal function testing. Current concept: Routine collaboration between pediatric surgeons and facility-based pediatricians enables continuous perioperative management. Preoperatively, patient background, nutritional status, and family preferences are recorded through structured communication and shared decision-making tools, such as the Ottawa Personal Decision Guide. During hospitalization, multidisciplinary evaluations include bioelectrical impedance analysis for nutritional assessment, endoscopic and pH impedance testing for swallowing function, and multichannel intraluminal impedance monitoring for gastroesophageal reflux. Postoperatively, periodic facility rounds ensure ongoing evaluation, with repeated assessments guiding nutritional optimization, early complication detection, and timely surgical consultation. This approach provides families and healthcare teams with detailed information on functional outcomes, strengthens trust, and enhances continuity of care. Sustained bedside engagement at facilities for neurologically impaired patients improves pre- and postoperative monitoring, promotes seamless collaboration between institutions, and ensures individualized evaluation of nutrition, swallowing, and gastrointestinal function. Conclusion: By providing actionable data to families and multidisciplinary teams, this model strengthens shared decision-making and supports long-term outcomes. The system may serve as a framework for integrated perioperative care in similar high-risk patient populations.
Masui et al. (Mon,) studied this question.