A narrative review on perioperative care in Duchenne muscular dystrophy (DMD) says multidisciplinary coordination is increasingly critical as patients live longer, undergo newer procedures, and face cardiac dysfunction as a main driver of survival. For NPs and PAs on the front lines, that means your assessment, medication reconciliation, and care coordination are central to safer anesthesia planning in an older, more medically fragile DMD population.

Why It Matters To Your Practice

• DMD is no longer managed only in younger patients undergoing routine procedures; many patients now present older, with complex cardiorespiratory disease and assisted ventilation.

• The review highlights that cardiac function has become a key determinant of survival, raising the stakes for perioperative screening and escalation.

• NPs and PAs are often the clinicians who catch evolving risks first, from respiratory compromise to medication issues to signs of Heart Failure (CHF).

Clinical Benefits

• Your pre-op history-taking can surface multisystem concerns that directly affect anesthetic choice, airway planning, and post-op monitoring.

• Careful review of newer heart failure therapies, ventilation needs, and neuromuscular status can help the team tailor perioperative care.

• Regional anesthesia advances and newer reversal strategies may help reduce cardiorespiratory stress in selected patients.

Managing Risks

• DMD affects muscular, respiratory, and cardiac systems at once, so isolated clearance is not enough; these patients need coordinated perioperative planning.

• Medication changes matter: newer guideline-directed heart failure drugs and other DMD-related therapies may have anesthetic implications.

• Frontline clinicians should flag frailty, ventilatory dependence, worsening cardiac symptoms, and prior anesthesia issues early so specialists can adjust the plan.

The Bottom Line

• This review makes clear that perioperative safety in DMD depends on multidisciplinary management, not last-minute handoffs.

• NPs and PAs are not supporting players here; you are often the operational center of risk recognition, cross-team communication, and continuity that keeps these vulnerable patients safe.

• In Duchenne periop care, your vigilance is a clinical advantage, not an accessory.