The Impact of Mean Arterial Pressure During Cardiopulmonary Bypass on Postoperative Outcomes in Coronary Artery Bypass Graft Surgery Publisher



A Shamsi AFZAL ; S Salim Alaroofa SENAN ; Md Firoozabadi Mehdi DEHGHANI ; Da Alkazzaz Dena A ; B Nooralishahi BEHRANG ; Mj Mehrabanian Mohammadjavad JAVAD
Source: Journal of Tehran University Heart Center Published:2024

Abstract

Background: Maintaining an optimal mean arterial pressure (MAP) is vital for cerebral blood flow and the overall health of patients undergoing coronary artery bypass graft (CABG) surgery. This study investigated the impact of low MAP on cerebral blood flow and in-hospital clinical outcomes in CABG candidates at our hospital. Methods: We compared a convenience sample of 55 patients with a low MAP (55 mmHg) and 54 patients with a high MAP (75 mmHg) who underwent CABG at Tehran Heart Center in 2023. We recorded the patients' demographic and clinical characteristics by measuring cerebral oximeter readings and lactate levels pre-and post-operation. We then compared the baseline and postoperative characteristics between the 2 groups and determined the impact of MAP on their postoperative changes. Results: The groups were statistically similar at baseline, except for a lower pH in the low MAP group (55 mmHg) (P=0.016). The preoperative and postoperative measurements (including lactate levels and cerebral oximeter readings) did not differ between the groups. However, heart rate was significantly higher in the high MAP group (75 mmHg) (P=0.034). The adjusted effect of baseline MAP on selected postoperative characteristics showed that it could significantly but inversely influence heart rate (β coefficient=-5.952; P=0.017) and had a borderline effect on troponin (β coefficient=1.734; P=0.051) and HCO3 (β coefficient=0.785; P=0.062). Conclusion: MAP did not significantly influence clinical outcomes in our study. Nonetheless, maintaining an optimal MAP is essential for preventing cerebral injury and ensuring adequate cerebral oxygenation in CABG patients. © 2024 Elsevier B.V., All rights reserved.