Mean arterial pressure difference before and during cardiopulmonary bypass: what should be the ideal mean perfusion pressure? Diferencia de la presión arterial media antes y durante un bypass cardiopulmonar: ¿cuál debe ser la presión de perfusión media ideal?

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Amaç B., Ersoy M., Bağiş M. Z., Padak M.

Cirugia y Cirujanos, cilt.93, sa.4, ss.425-433, 2025 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 93 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.24875/ciru.24000300
  • Dergi Adı: Cirugia y Cirujanos
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.425-433
  • Anahtar Kelimeler: Cardiopulmonary bypass, Mean arterial pressure, Mean perfusion pressure, Acute kidney injury, Mean arterial pressure-mean perfusion pressure difference
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objectives: The difference between mean arterial pressure (MAP) before cardiopulmonary bypass (CPB) and mean perfusion pressure (MPP) during CPB is thought to be a strong predictor of acute kidney injury (AKI). In this study, we aimed to evaluate whether the difference between MAP and MPP is a good index to predict the development of AKI and what the ideal MPP should be during CPB. Methods: A total of 296 consecutive patients were included in this retrospective study. MAP-MPP differences of patients who developed AKI and those who did not develop AKI according to standard guidelines and their relation with adverse outcomes were evaluated. Results: MAP values of patients who did not develop AKI and patients who developed AKI were higher in the group with AKI, 67.60 mmHg versus 64.84 mmHg (p = 0.001). The MAP-MPP difference was 5.07 in the group without AKI and 9.44 in the group with AKI (p = 0.000). Conclusion: We found that the difference between MAP and MPP is a good index for predicting the development of CPB-related AKI and poor outcomes. We also suggest that patients’ preoperative arterial blood pressure should be taken into account for an ideal MPP.