Impact of 2 Distinct Levels of Mean Arterial Pressure on Near-Infrared Spectroscopy During Cardiac Surgery: Secondary Outcome From a Randomized Clinical Trial

Anesthesia and Analgesia
Frederik HolmgaardHanne Berg Ravn

Abstract

Near-infrared spectroscopy (NIRS) is used worldwide to monitor regional cerebral oxygenation (rScO2) during cardiopulmonary bypass (CPB). Intervention protocols meant to mitigate cerebral desaturation advocate to increase mean arterial pressure (MAP) when cerebral desaturation occurs. However, the isolated effect of MAP on rScO2 is uncertain. The aim of the present study was in a randomized, blinded design to elucidate the effect of 2 distinct levels of MAP on rScO2 values during CPB.We hypothesized that a higher MAP would be reflected in higher rScO2 values, lower frequency of patients with desaturation, and a less pronounced cerebral desaturation load. This is a substudy of the Perfusion Pressure Cerebral Infarct trial, in which we investigated the impact of MAP levels during CPB on ischemic brain injury after cardiac surgery. Deviation in rScO2 was a predefined outcome in the Perfusion Pressure Cerebral Infarct trial. Patients were randomized to low MAP (LMAP; 40-50 mm Hg) or high MAP (HMAP; 70-80 mm Hg) during CPB. CPB pump flow was fixed at 2.4 L/min/m, and MAP levels were targeted using norepinephrine. Intraoperatively, NIRS monitoring was performed in a blinded fashion, with sensors placed on the left and right side of t...Continue Reading

References

Aug 23, 2001·The Annals of Thoracic Surgery·J M SlaterD J Cook
Dec 17, 2003·Acta Anaesthesiologica Scandinavica·J Ahonen, M Salmenperä
May 28, 1902·The Journal of Physiology·W M Bayliss
Dec 21, 2006·Anesthesia and Analgesia·John M MurkinStephanie Fox
Jan 25, 2008·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Priscila A CassagliaAdrian M Walker
Feb 14, 2008·Seminars in Cardiothoracic and Vascular Anesthesia·André DenaultJohn M Murkin
Dec 23, 2008·The Annals of Thoracic Surgery·James P SlaterGrant V S Parr
Apr 21, 2009·British Journal of Anaesthesia·P BrassardN H Secher
Dec 24, 2010·Anesthesiology·Matthias HeringlakeThorsten Hanke
Nov 23, 2011·Anesthesia and Analgesia·Brijen JoshiCharles W Hogue
May 29, 2015·Journal of Clinical Monitoring and Computing·Ai HirasawaShigehiko Ogoh
Sep 30, 2015·Current Opinion in Anaesthesiology·Anneliese Moerman, Stefan De Hert
Jan 26, 2016·Anesthesiology·Alain DeschampsUNKNOWN Canadian Perioperative Anesthesia Clinical Trials Group
Mar 26, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Ove Andreas HagenKnut Arvid Kirkebøen
Jan 6, 2017·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Kensuke KobayashiKagami Miyaji
Jan 26, 2017·Journal of Clinical Monitoring and Computing·Thomas W L Scheeren, Bernd Saugel

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Citations

May 28, 2019·Journal of Clinical Monitoring and Computing·Frederik HolmgaardThomas W L Scheeren
Oct 1, 2019·Anesthesia and Analgesia·Olivier DesebbeAndre Denault
Oct 1, 2019·Anesthesia and Analgesia·Frederik HolmgaardHanne B Ravn
Jun 21, 2019·Anesthesiology·Louise Y Sun, Marc Ruel
Jun 21, 2019·Anesthesiology·Hanne Berg RavnFrederik Holmgaard

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