Abstract
<title>Abstract</title> <p> Background This study aimed to identify the characteristics of Paroxysmal sympathetic hyperactivity (PSH) in pediatric patients after brain tumor resection in the Intensive Care Unit (ICU), screen laboratory markers for early auxiliary diagnosis, and explore effective intravenous treatment regimens. Methods Pediatric patients who underwent brain tumor resection between January 2020 and December 2022 were enrolled. SPSS version 26.0 was used for data processing and analysis. Results The incidence of PSH after pediatric brain tumor resection was 15.6%. Younger age and preoperative hydrocephalus were identified as independent risk factors. Optimal cut-off values were determined for blood lactate (2.55 mmol/L) and blood glucose (7.27 mmol/L). Dexmedetomidine combined with remifentanil resulted in a significantly greater reduction in PSH scores at 1 hour after treatment compared to other treatments ( <italic>P</italic> < 0.05). The length of ICU stay was significantly longer in the PSH-positive group (3.33 ± 3.89 days) than in the PSH-negative group (1.64 ± 2.42 days) ( <italic>P</italic> = 0.027), and the 1-year mortality rate (13.3%) was significantly higher in the PSH-positive group than in the PSH-negative group (1.9%) ( <italic>P</italic> = 0.012). Conclusions PSH is not uncommon after pediatric brain tumor resection. Younger age and preoperative hydrocephalus are independent risk factors. Blood lactate and blood glucose may serve as auxiliary diagnostic indicators. Dexmedetomidine combined with remifentanil may represent an effective therapeutic regimen for PSH. PSH episodes are associated with a prolonged ICU stay and an increased risk of mortality. </p>