The Optimal mean arterial blood pressure during cardiopulmonary bypass: does one fit all?
| Author | Affiliation |
|---|---|
Krakauskaitė, Solventa | Kauno technologijos universitetas |
Putnynaitė, Vilma | Kauno technologijos universitatas |
Chaleckas, Edvinas | Kauno technologijos universitatas |
| Date |
|---|
2022-06-04 |
no. 07AP05-05
Cardiac, Thoracic and Vascular Anaesthesiology 1
Background and Goal of Study: Recent investigations have demonstrated that limits of cerebrovascular autoregulation (CA) are patient specific and may exceed the lower and the upper limits of CA in healthy individuals. The goal of the study was to detect impaired CA during cardiac surgery with cardiopulmonary bypass (CPB) and estimate the individual limits of mean arterial blood pressure (mABP) within which the individual CA remains intact. Materials and Methods: The prospective observational study was conducted at Kaunas Klinikos, the Hospital of Lithuanian University of Health Sciences. The patients undergoing elective coronary artery bypass grafting (CABG) surgery were included. In addition to standard monitoring CA was monitored in real time by “Vittamed” non-invasive monitor. The method is based on monitoring of intracranial blood volume (IBV) changes. Non invasively monitored volumetric reactivity index (VRx(t)) correlates with invasive PRx(t). Results and Discussion: 65 patients were enrolled in the study. All patients were ASA III class, NYHA III class; their average age was 70 years; average mABP = 63.35 mmHg during CPB. All patients had periods of impaired CA. The mean longest impairment lasted 6.5 min. Average total duration of CA impairments was 25.98 min. (29.57 % of CPB). Though analysis within the study group revealed that mABP was not related with CA disorders individual study of mABP and CA impairments revealed that in 33 patients the limits of CA did not correspond to the currently known limits of the intact CA (Fig.1-2). […].