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BMC Anesthesiology

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Open Access 01-12-2019 | Incision | Research article

Newborn infant parasympathetic evaluation (NIPE) as a predictor of hemodynamic response in children younger than 2 years under general anesthesia: an observational pilot study

Authors: Kan Zhang, Siyuan Wang, Lei Wu, Yun’an Song, Meihua Cai, Mazhong Zhang, Jijian Zheng

Published in: BMC Anesthesiology | Issue 1/2019

Abstract

Background

It is still unknown whether newborn infant parasympathetic evaluation (NIPE), based on heart rate variability (HRV) as a reflection of parasympathetic nerve tone, can predict the hemodynamic response to a nociception stimulus in children less than 2 years old.

Methods

Fifty-five children undergoing elective surgery were analyzed in this prospective observational study. Noninvasive mean blood pressure (MBP), heart rate (HR) and NIPE values were recorded just before and 1 min after general anesthesia with endotracheal intubation as well as skin incision. The predictive performance of NIPE was evaluated by receiver-operating characteristic (ROC) curve analysis. A significant hemodynamic response was defined by a > 20% increase in HR and/or MBP.

Results

Endotracheal intubation and skin incision caused HR increases of 22.2% (95% confidence interval [CI] 17.5–26.9%) and 3.8% (2.1–5.5%), MBP increases of 18.2% (12.0–24.4%) and 10.6% (7.7–13.4%), and conversely, NIPE decreases of 9.9% (5.3–14.4%) and 5.6% (2.1–9.1%), respectively (all P < 0.01 vs. pre-event value). Positive hemodynamic responses were observed in 32 patients (62.7%) during tracheal intubation and 13 patients (23.6%) during skin incision. The area under the ROC curve values for the ability of NIPE to predict positive hemodynamic responses at endotracheal intubation and skin incision were 0.65 (0.50–0.78) and 0.58 (0.44–0.71), respectively.

Conclusions

NIPE reflected nociceptive events as well as anesthestic induction in children less than 2 years undergoing general anaesthetia. Nevertheless, NIPE may not serve as a sensitive and specific predictor to changes in hemodynamics.

Trial registration

This study was registered on May 3, 2018 in the Chinese Clinical Trail Registry; the registration number is (ChiCTR1800015973).

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Title: Newborn infant parasympathetic evaluation (NIPE) as a predictor of hemodynamic response in children younger than 2 years under general anesthesia: an observational pilot study
Authors: Kan Zhang
Siyuan Wang
Lei Wu
Yun’an Song
Meihua Cai
Mazhong Zhang
Jijian Zheng
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Incision
General Anesthesia
Published in: BMC Anesthesiology / Issue 1/2019
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-019-0774-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Newborn infant parasympathetic evaluation (NIPE) as a predictor of hemodynamic response in children younger than 2 years under general anesthesia: an observational pilot study

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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