Overview

This prospective randomized controlled trial evaluates whether individualized cardiac index-guided intraoperative hemodynamic management reduces postoperative transient ischemic episodes in pediatric patients undergoing encephaloduroarteriosynangiosis (EDAS) for Moyamoya disease. Patients are randomized 1:1 to goal-directed fluid therapy based on baseline cardiac index versus standard arterial pressure-based management. The primary outcome is the incidence of transient ischemic episodes during hospitalization.

Eligibility

Inclusion Criteria:

• Pediatric patients \<18 years undergoing EDAS for Moyamoya disease under general anesthesia

Exclusion Criteria:

• ASA physical status 4-5
• Emergency surgery
• Known cardiovascular disease
• Any condition judged inappropriate by investigators