Paediatric Neuromuscular Scoliosis and Post-Operative Blood Pressure Targets

Paediatric neuromuscular scoliosis patients undergoing spinal deformity surgery lack evidence-based postoperative blood pressure targets to protect spinal cord perfusion. This thesis shows that sustained mean arterial pressure (MAP) below 60–65 mmHg is common and usually tolerated, but prolonged exposure is associated with biochemical markers of global hypoperfusion. Using artefact-filtered invasive MAP data from 101 cases, the study quantified hypotension burden with time and area-under-threshold metrics and modelled associations with lactate, urine output and acute kidney injury. Findings support moderate MAP thresholds and highlight the need for prospective studies with direct perfusion monitoring to refine haemodynamic guidelines.