Development of Normative Ranges for Vital Signs and Differentiation by American Society of Anesthesiologists Physical...

Normative ranges for vital signs under general anesthesia are well established for healthy pediatric patients, but the influence of The American Society of Anesthesiologists Physical Status (ASA-PS) classification on these normative ranges remains unexplored. The purpose of this study is to develop age-based normative ranges for heart rate (HR) and blood pressure (BP) in patients undergoing general anesthesia for noncardiac surgery in our institution and assess differences by ASA-PS classification. This is a retrospective observational single-center study. We reviewed all anesthetic records from the Hospital for Sick Children, Canada between March 1st and December 31st, 2023. We extracted physiological data from our in-house high-resolution physiological data repository (AtriumDB) to develop normative ranges for physiological parameters and compared them according to ASA-PS classification. We developed age-based normative ranges for BP and HR. We found significant differences between ASA-PS groups, most notably between ASA-PS 1 and 5. We found a statistically significant difference between ASA-PS 1-2 and 3-5 across all physiological parameters. This study validates existing pediatric anesthesia reference ranges while demonstrating the feasibility of incorporating patients across the spectrum of ASA-PS. Further multicenter studies are needed to generalize these findings.