2018 Volume 22 Issue 1 Pages 55-60
Objective: There is no protocol to decide an adequate perfusion pressure during cardiopulmonary bypass (CPB). The aim of this study was to investigate the relationships between hypertension observed just before anesthesia, CPB-related factors and postoperative lactate levels to determine the benefit of adjusting the perfusion pressure depending on pre-operative hypertension.
Methods: We have reviewed patients who underwent cardiac surgery under CPB and divided them into hypertension (HTN) and non-hypertension (No HTN) groups, depending on the blood pressure just before anesthesia. We have analyzed the relationship between the maximum lactate levels within 10 hours following the operation and pre-operative and intra-operative factors, including CPB-related factors in both groups, using univariate and multivariate analysis.
Results: Ninety-one patients (HTN group; n=45, Non HTN group; n=46) were involved in this study and there was no significant difference in post-operative maximum lactate levels between the two groups. We found a significant association between the duration of CPB and postoperative lactate levels in both groups, and a significant association between the ratio of mean arterial blood pressure before anesthesia and mean perfusion pressure during CPB with postoperative lactate levels in HTN group.
Conclusion: It was suggested that not only short duration of CPB but also an adjustment of perfusion pressure during CPB, depending on the hypertensive state before anesthesia, was important to reduce postoperative lactate levels.
