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Effect of perfusion pressure on the splanchnic circulation after CPB: a pilot study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
Austin Hosp, Dept Anaesthesia, Melbourne, Vic 3084, Australia..
Austin Hosp, Dept Anaesthesia, Melbourne, Vic 3084, Australia..
Austin Hosp, Dept Anaesthesia, Melbourne, Vic 3084, Australia..
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2015 (English)In: Minerva Anestesiologica, ISSN 0375-9393, E-ISSN 1827-1596, Vol. 81, no 7, 752-764 p.Article in journal (Refereed) Published
Abstract [en]

Background. The impact of different blood pressure targets is unknown for post cardiac surgery patient in the intensive care unit. We, therefore, investigated the effects of a mean arterial pressure (MAP) target of 65 or 85 mmHg on splanchnic oxygenation, metabolic function, cytokine regulation and gastric tonometry after cardiopulmonary bypass. Methods. Sixteen patients were randomized to the HLH group (high-low-high) where MAP of 85-65-85 mmHg was targeted or the LHL group where MAP 65-85-65 mmHg was targeted with norepinephrine Results. MAP targets were achieved in all patients at all timepoints (64 +/- 3, 84 +/- 4; 65 +/- 5, LHL group; vs. 84 +/- 3; 66 +/- 2; 85 +/- 5 mmHg, HLH group). At corresponding timepoints, hepatic venous saturation was 41 +/- 15%; 58 +/- 24%; 56 +/- 21% in the LHL group vs. 50 +/- 19%; 43 +/- 20%; 41 +/- 18% in the HLH group (P<0.05). No changes were observed in cardiac output, global or trans-splanchnic lactate levels and cytokine levels or in gastric tonometry CO2. Conclusion. Achieving a MAP target of 85 mmHg by means of norepinephrine infusion after CPB appears safe for the splanchnic circulation.

Place, publisher, year, edition, pages
2015. Vol. 81, no 7, 752-764 p.
Keyword [en]
Intensive Care Unit, Cardiac surgical procedures, Blood pressure, Splanchnic circulation, Cytokines
National Category
Anesthesiology and Intensive Care
URN: urn:nbn:se:uu:diva-265602ISI: 000362381600009PubMedID: 25357214OAI: oai:DiVA.org:uu-265602DiVA: diva2:866350
Available from: 2015-11-02 Created: 2015-11-02 Last updated: 2015-11-02Bibliographically approved

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