Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
E-pub ahead of print

Blood pressure and brain injury in cardiac surgery: a secondary analysis of a randomized trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. 2019 EACTS Expert Consensus on long-term mechanical circulatory support

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Intraoperative flow profiles of arterial and venous bypass grafts to the left coronary territory

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Lung transplantation after ex vivo lung perfusion in two Scandinavian centres

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Association between transfusion of blood products and acute kidney injury following cardiac surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Apolipoprotein E ε4 and cognitive function after surgery in middle-aged and elderly Danish twins

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Spontaneous Subarachnoid Haemorrhage as a Cause of Out-of-Hospital Death

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Evaluation of inflammatory lesions over 2 years in facioscapulohumeral muscular dystrophy

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVES: Brain dysfunction is a serious complication after cardiac surgery. In the Perfusion Pressure Cerebral Infarcts trial, we allocated cardiac surgery patients to a mean arterial pressure of either 70-80 or 40-50 mmHg during cardiopulmonary bypass (CPB). In this secondary analysis, we compared selected cerebral metabolites using magnetic resonance spectroscopy hypothesizing that a postoperative decrease in occipital grey matter (GM) N-acetylaspartate-to-total-creatine ratio, indicative of ischaemic injury, would be found in the high-target group.

METHODS: Of the 197 patients randomized in the Perfusion Pressure Cerebral Infarcts trial, 55 and 42 patients had complete and useful data from GM and white matter (WM), respectively. Spectroscopies were done preoperatively and on postoperative days 3-6. Cognitive function was assessed prior to surgery, at discharge and at 3 months. We predefined the statistical significance level to be 0.01.

RESULTS: A postoperative decrease was found in GM N-acetylaspartate-to-total-creatine ratio in the high-target group [mean difference -0.09 (95% confidence interval -0.14 to -0.04), P = 0.014]. No significant differences were found in other metabolite ratios investigated in GM or WM. No significant association was found between changes in metabolite ratios and new cerebral infarcts, WM lesion score or cognitive dysfunction.

CONCLUSIONS: A higher mean arterial pressure during CPB was associated with signs of impaired cerebral metabolism, though not at the predefined significance level of 0.01. No significant association was found between metabolite ratio changes and neuroradiological pathology or change in cognitive function.

CLINICAL TRIAL REGISTRATION NUMBER: Clinicaltrials.gov: NCT02185885.

OriginalsprogEngelsk
TidsskriftEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
ISSN1010-7940
DOI
StatusE-pub ahead of print - 25 aug. 2020

Bibliografisk note

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

ID: 60799112