Carotid Artery Blood Flow, Blood Pressure, and Cardiac Output During Anesthesia in Children Aged 0-5 Years

Blood pressure is routinely monitored during anesthesia in children, but blood pressure alone may not accurately reflect blood flow to vital organs. This is particularly important in infants and young children, in whom normal cardiovascular values vary with age. The CARFLOW study is a prospective observational study of 100 children aged 0-5 years undergoing anesthesia and surgery. The purpose is to investigate how blood flow in the common carotid artery, measured non-invasively using Doppler ultrasound, relates to blood pressure and cardiac output during anesthesia. Carotid artery blood flow will be measured before and during anesthesia and compared with blood pressure recorded as part of routine monitoring. In children who are intubated, cardiac output will also be measured non-invasively using a capnodynamic method. The main questions are whether changes in blood pressure are associated with changes in carotid artery blood flow, how carotid artery blood flow relates to cardiac output, and whether reference values for carotid artery blood flow during anesthesia can be established for young children. All clinical decisions and treatment will follow routine clinical practice. Measurements performed as part of the study will not be used to guide treatment.

Inclusion Criteria: * Age 0-5 years * Scheduled for elective surgery under general anesthesia at the Pediatric Operating Department, Karolinska University Hospital * Written informed consent provided by a parent or legal guardian Exclusion Criteria: * Emergency surgery * American Society of Anesthesiologists (ASA) physical status ≥3 * Significant comorbidity * Expected complicated anesthesia or surgical procedure * Parent or legal guardian does not provide informed consent