Abstract
<jats:p>INTRODUCTION: Intraoperative critical incidents (CI) in children are common due to anatomical and physiological features, limited compensatory reserves and sensitivity to external influences. The search for non-invasive functional tests to assess the risk of CI in the daily practice of pediatric anesthesiology remains relevant. OBJECTIVE: Determine the prognostic role of the duration of breath-holding test (BHT) after deep inspiration in assessing the risk of intraoperative critical incidents in children. MATERIALS AND METHODS: 160 children (5–10 years old, ASA 1–2, abdominal surgical operations) took part in a prospective observational study. All underwent combined anesthesia with sevoflurane inhalation on spontaneous breathing and bolus administration of fentanyl. The duration of BHT was assessed three times in the morning before surgery, the mean value was recorded. CI were defined according to the accepted criteria: hemodynamic (hypotension, bradycardia, etc.) and respiratory (hyper-/hypocapnia, hypoxemia, etc.). Statistical analysis was performed using ROC analysis and AUC calculation. RESULTS: Critical incidents were registered in 39 (24.3 %) children, mainly hemodynamic: hypotension (HT, 26 cases) and bradycardia (BC, 31 cases). In children with CI, the duration of BHT was statistically significantly shorter (p < 0.05). According to the results of ROC analysis, with BHT ≤ 30 sec, the probability of hypotension increased, with BHT ≤ 25 sec the risk of bradycardia increased. AUC for CI was 0.883. CONCLUSIONS: Insufficient duration of BHT (< 28 sec) significantly increases the risk of developing intraoperative critical incidents in children, mainly hemodynamic.</jats:p>