Key result
Noradrenaline and phenylephrine used to elevate mean arterial pressure during cardiopulmonary bypass caused a similar, clinically non-significant 2.0% decrease in cerebral oxygen saturation.
Why the study?
Vasopressors counteract hypotension during cardiopulmonary bypass but alpha-agonists have been linked to cerebral desaturation, which can increase postoperative neurological dysfunction.
Does noradrenaline compared to phenylephrine affect cerebral oxygen saturation in patients undergoing elective cardiac surgery with cardiopulmonary bypass?
Population
36 patients scheduled for elective cardiac surgery
Comparison
Noradrenaline vs phenylephrine during cardiopulmonary bypass
Design
Randomized controlled trial
Authors
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Clinically insignificant ScO2 drops with NA or PE during CPB warrant no practice change; leaves open neurological outcome effects in larger trials.
RCT (n=36)
Does noradrenaline compared to phenylephrine affect cerebral oxygen saturation in patients undergoing elective cardiac surgery with cardiopulmonary bypass?
Effect estimate: mean relative decrease 2.0% (95% CI 0.6 to 2.1)
p-value: p=<0.01
Elevation in MAP mediated solely by vasopressors (noradrenaline or phenylephrine) induces statistically significant but clinically non-significant decreases in cerebral oxygen saturation during cardiac surgery under CPB.
Marques et al. (2025) conducted an RCT in Elective cardiac surgery under cardiopulmonary bypass (n=36). Noradrenaline vs. Phenylephrine was evaluated on Cerebral oxygen saturation (mean relative decrease 2.0%, 95% CI 0.6 to 2.1, p=<0.01). Noradrenaline and phenylephrine used to elevate mean arterial pressure during cardiopulmonary bypass caused a similar, clinically non-significant 2.0% decrease in cerebral oxygen saturation.
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