Related Experiment Video
Updated: Feb 4, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Predictive value of intraoperative hemodynamics and heart rate variability for postoperative emergence quality in
1Department of Anesthesiology, Children's Hospital of Soochow University, Suzhou, 215000, Jiangsu Province, China. xieyxchsu@shu-edu.cn.
Insights
Stable intraoperative hemodynamics and higher heart rate (HR) variability predict better emergence in pediatric patients after VSD closure. This combined assessment offers high accuracy for predicting postoperative emergence quality.
Area of Science:
- Pediatric Anesthesiology
- Cardiovascular Surgery
- Autonomic Nervous System Research
Background:
- Transcatheter closure of ventricular septal defects (VSD) is a common pediatric procedure.
- Postoperative emergence quality is a critical outcome measure in pediatric anesthesia.
- Predicting emergence quality can help optimize patient care and reduce complications.
Purpose of the Study:
- To evaluate the predictive value of intraoperative hemodynamics and heart rate (HR) variability for postoperative emergence quality in children undergoing transcatheter VSD closure.
- To identify specific hemodynamic and HR variability parameters associated with good or poor emergence.
- To assess the combined predictive accuracy of these parameters.
Main Methods:
- A cohort of 110 pediatric patients undergoing transcatheter VSD closure were studied.
- Patients were categorized into good and poor emergence groups based on emergence delirium/agitation.
- Hemodynamic and HR variability parameters were recorded at four intraoperative time points.
Main Results:
- The good emergence group exhibited significantly lower HR and higher blood pressure compared to the poor emergence group.
- Higher total power (TP), high-frequency (HF) components, and lower LF/HF ratio of HR variability were observed in the good emergence group.
- The combined assessment of intraoperative hemodynamics and HR variability achieved an AUC of 0.892, with 93.55% sensitivity and 79.75% specificity.
Conclusions:
- More stable intraoperative hemodynamics and higher HR variability are associated with better postoperative emergence quality in pediatric patients.
- The combined predictive model demonstrates significant clinical utility for anticipating emergence outcomes.
- These findings support the integration of hemodynamic and HR variability monitoring for enhanced perioperative care.
Background:
To study the predictive values of intraoperative hemodynamics and heart rate (HR) variability for the postoperative emergence quality of children undergoing transcatheter closure of ventricular septal defects.
Methods:
A total of 110 pediatric patients treated from January 2023 to January 2024 were divided into good and poor emergence groups according to the presence of emergence delirium and/or agitation. Hemodynamic and HR variability parameters were recorded at four time points (T0: start of surgery; T1: 30 min; T2: 60 min; T3: 30 min before end).
Results:
The good emergence group showed significantly lower HR from T0 to T3 and higher systolic and diastolic blood pressure from T1 to T3 and T2 to T3 compared with the poor emergence group (P < 0.05). Across T0-T3, total power (TP), high-frequency (HF), and low-frequency (LF) components were significantly higher, whereas the LF/HF ratio was significantly lower in the good emergence group (P < 0.05). At T2, TP was 586.20 ± 130.07 ms² versus 422.16 ± 86.85 ms², HF was 152.36 ± 26.02 ms² versus 93.57 ± 20.49 ms², and the LF/HF ratio was 1.07 ± 0.16 versus 1.35 ± 0.29 in the good and poor groups, respectively. The combined predictive value of intraoperative hemodynamics and HR variability showed an AUC of 0.892 (95% CI: 0.825-0.959), with 93.55% sensitivity and 79.75% specificity.
Conclusions:
More stable intraoperative hemodynamics and higher HR variability were associated with better postoperative emergence quality. The combined assessment demonstrated high predictive accuracy, suggesting potential clinical utility.
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