Abstract

Commentary

Is there an ideal blood pressure during cardiopulmonary bypass to prevent postoperative cerebral injury? – What does the recent evidence say?

Ahmed Zaky*

Published: 21 November, 2018 | Volume 3 - Issue 3 | Pages: 104-105

Post cardiac surgery stroke is a devastating complication with an incidence as high as 50%1. The association between intra-operative mean arterial blood pressure (MAP- better called linear blood pressure) during cardiopulmonary bypass (CPB) and the development of postoperative stroke-as diagnosed by neuroimaging- and of cognitive dysfunction (POCD) is controversial. This is due to differences in the study populations, stroke assessment tools, operation and conduction of MAPs, variations in neurocognitive testing and duration of follow up. As a result there is a gap in the knowledge on an ideal MAP as a preventive measure of post CPB stroke and POCD.

Read Full Article HTML DOI: 10.29328/journal.jccm.1001031 Cite this Article Read Full Article PDF

References

  1. Tarakji KG, Sabik JF, 3rd, Bhudia SK, Batizy LH, Blackstone EH. Temporal onset, risk factors, and outcomes associated with stroke after coronary artery bypass grafting. JAMA. 2011; 305: 381-390. Ref.: https://goo.gl/CVG9er
  2. Gottesman RF, Sherman PM, Grega MA, Yousem DM, Borowicz LM, Jr., et al. Watershed strokes after cardiac surgery: diagnosis, etiology, and outcome. Stroke. 2006; 37: 2306-2311. Ref.: https://goo.gl/v3LZ88
  3. Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001; 344: 395-402. Ref.: https://goo.gl/9ENmb1

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