Objective: This study aimed to identify perioperative anesthesia monitoring parameters associated with adverse postoperative outcomes in neonates with NEC.

Methods: A cross-sectional study was conducted among neonatal patients with NEC who were admitted to the Women’s and Children’s Hospital Affiliated to Chongqing Medical University/Chongqing Health Center for Children and Women between January 2023 and March 2025. Patients who experienced adverse outcomes within 28 days after surgery were included in the study group (n=27), and those with favorable outcomes were assigned to the control group(n=69).

Results: A total of 96 patients were included in the study, of whom 59(61.5%) were male and 37(38.5%) were female. The preoperative SNAP-II was 21(IQR,15-28). The study group had significantly longer cumulative hypotension time [46(IQR, 31-70) min vs 22(IQR, 11-36) min], higher peak lactate levels [4.0 (IQR, 3.1-5.4) mmol/L vs 2.6 (IQR, 2.0-3.4) mmol/L] and VIS [22 (IQR, 12-34) vs 12 (IQR, 6-20)] than the control group (P<0.05). Multivariable logistic regression analysis showed that cumulative hypotension time [OR=1.19 (95% CI, 1.06-1.36), P=0.01], peak lactate level [OR=1.28 (95% CI, 1.05-1.59), P=0.02] and VIS [OR=1.21 (95% CI, 1.09-1.52), P=0.04] were independent risk factors for adverse postoperative outcomes in NEC. The combined predictive model demonstrated good performance[AUC=0.80(95% CI, 0.71-0.88)].

Conclusion: Cumulative hypotension time, peak lactate level, and VIS were independent perioperative anesthesia monitoring parameters that predicted adverse postoperative outcomes in NEC.

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