Key result
Sustained high MAP during CPB fails to prevent AKI compared to low MAP.
Why the study?
The study was conducted to evaluate the role of higher mean arterial pressure during cardiopulmonary bypass in preventing the development of acute kidney injury in elderly patients.
Does sustained high mean arterial pressure (>65 mmHg) during cardiopulmonary bypass prevent acute kidney injury in elderly patients undergoing cardiac surgery?
Cohort (n=92)
Does sustained high mean arterial pressure (>65 mmHg) during cardiopulmonary bypass prevent acute kidney injury in elderly patients undergoing cardiac surgery?
Maintaining a higher mean arterial pressure (>65 mmHg) during cardiopulmonary bypass does not significantly reduce the incidence of acute kidney injury in elderly patients undergoing cardiac valve surgery.
High MAP during bypass was not associated with lower AKI risk in this elderly cohort; leaves open whether randomized trials would alter targets.
We aimed to evaluate the role of higher mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) in preventing development of acute kidney injury (AKI). Methods. We evaluated a population of elderly individuals >60 years of age undergoing CPB to find correlation of MAP during CPB with development of AKI after the surgery. Patients who experienced sustained low MAP during the CPB defined as that of <65 mmHg were compared with those that had sustained high MAP of >65 mmHg for their outcome with regard to AKI. The KDIGO criteria were used to define presence of acute kidney injury. Results. Of the total 92 patients, 50 were in the low‐pressure group and 42 were in the high‐pressure group. The MAP was 61.14 ± 5.54 mmHg in the low‐pressure group and 68.97 ± 3.65 mmHg in the high‐pressure group (p < 0.001). 13 (26%) in the low‐pressure group and 17 (40.48%) in the high‐pressure group developed AKI (p = 0.140). Male sex was associated with an increased incidence of cardiac surgery‐associated AKI (p = 0.034). Conclusions. A higher MAP in the range of 65–75 mmHg during the cardiopulmonary bypass does not significantly prevent acute kidney injury in elderly patients undergoing cardiac valve surgery.
No takes yet. Share an insight, caveat, or question.
Ge et al. (2022) conducted a cohort in Cardiac surgery requiring cardiopulmonary bypass (n=92). Sustained high mean arterial pressure (>65 mmHg) vs. Sustained low mean arterial pressure (<65 mmHg) was evaluated on Acute kidney injury (KDIGO criteria) (p=0.140). Sustained high mean arterial pressure (>65 mmHg) during cardiopulmonary bypass did not significantly prevent acute kidney injury compared to low pressure (40.48% vs 26.0%; p=0.140).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: