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The Effects of Mean Arterial Pressure During Cardiopulmonary Bypass on Clinical and Paraclinical Parameters During and After Coronary Artery Bypass Graft Surgery



Bagheri K1 ; Motamedi O2 ; Aghadavoudi O3 ; Akbari M4
Authors
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Authors Affiliations
  1. 1. Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Intern, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2012

Abstract

Background: Cardiovascular disease is one of the most common causes of death in today's world. Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) is considered as a treatment for ischemic heart diseases. One of the conflicting points during CPB is maintaining optimum mean blood pressure. This study aimed to examine the impact of two different ranges of mean arterial pressure during CPB on intra- and post-operative clinical and paraclinical variables. Methods: In this randomized clinical trial study, two groups of 54 patients undergoing CABG surgery with CPB were enrolled. During CPB, blood pressure was maintained at about 50-70 mmHg in one group and 70-90 mmHg in the other group by administration of ephedrine and nitroglycerin. The patients were studied for blood gas, urine output, pace maker and inotrope requirements, arrhythmia, blood urea nitrogen (BUN), creatinine (Cr), cognition before, during and after the surgery, and also duration of intensive care unit (ICU) stay and intubation. Findings: In this study, two groups of 54 patients were enrolled. Overall, 92 (85%) subjects were male and 16 (15%) were female. Mean age of patients was 61.3 ± 9.3 years. Results showed that mean values of bicarbonate (Hco3), BE, arterial pressure of carbon dioxide (PCO2), arterial pressure of oxygen (PO2), BUN, Cr, duration of ICU stay, urine output, duration of intubation, level of cognition, pace maker and inotrope requirements and incidence of arrhythmia had significant relationships with blood pressure before, during, and after surgery. Meanwhile, pH did not have any significant relationships with blood pressure Conclusion: Overall results showed that prognosis in patients with controlled blood pressure at about 70-90 mmHg during CABG surgery was better compared to the group with a blood pressure of 50-70 mmHg. However, more studies seem necessary.
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