Optimal blood pressure during cardiopulmonary bypass defined by cerebral autoregulation monitoring

Journal of Thoracic and Cardiovascular Surgery

Volumn 154, Issue 5, 2017, Pages 1590-1598.e2

  Hori, Daijiro ^a   Nomura, Yohei ^a   Ono, Masahiro ^b   Joshi, Brijen ^a   Mandal, Kaushik ^a   Cameron, Duke ^a   Kocherginsky, Masha ^c   Hogue, Charles W ^c  

^a JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b TEXAS HEART INSTITUTE   (United States)

^c NORTHWESTERN UNIVERSITY   (United States)

Author keywords

blood pressure; cardiopulmonary bypass; cerebral autoregulation

Indexed keywords

DIURETIC AGENT;

ADULT; AGED; ARTICLE; AUTOREGULATION; BLOOD FLOW VELOCITY; BRAIN BLOOD FLOW; CARDIOPULMONARY BYPASS; CAROTID ENDARTERECTOMY; CEREBROVASCULAR ACCIDENT; FEMALE; HEART SURGERY; HUMAN; MAJOR CLINICAL STUDY; MALE; MEAN ARTERIAL PRESSURE; MIDDLE AGED; NEUROMONITORING; PRIORITY JOURNAL; TRANSCRANIAL DOPPLER ULTRASONOGRAPHY; TREATMENT DURATION; ARTERIAL PRESSURE; BLOOD PRESSURE MEASUREMENT; BRAIN; BRAIN CIRCULATION; BRAIN DISEASE; CARDIOVASCULAR DISEASE; HOMEOSTASIS; INTRAOPERATIVE MONITORING; NEAR INFRARED SPECTROSCOPY; OXIMETRY; POSTOPERATIVE COMPLICATION; PROCEDURES; REPRODUCIBILITY; VASCULARIZATION;

AGED; ARTERIAL PRESSURE; BLOOD FLOW VELOCITY; BLOOD PRESSURE DETERMINATION; BRAIN; BRAIN DISEASES; CARDIOPULMONARY BYPASS; CARDIOVASCULAR DISEASES; CEREBROVASCULAR CIRCULATION; FEMALE; HOMEOSTASIS; HUMANS; MALE; MIDDLE AGED; MONITORING, INTRAOPERATIVE; OXIMETRY; POSTOPERATIVE COMPLICATIONS; REPRODUCIBILITY OF RESULTS; SPECTROSCOPY, NEAR-INFRARED; STROKE; ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL;

EID: 85033689830     PISSN: 00225223     EISSN: 1097685X     Source Type: Journal    
DOI: 10.1016/j.jtcvs.2017.04.091     Document Type: Article

References (48)

1. Gibbon, J.H. Jr., Application of a mechanical heart and lung apparatus to cardiac surgery. Minn Med 37 (1954), 171–185 passim.
2. Hannan, E.L., Wu, C., Walford, G., Culliford, A.T., Gold, J.P., Smith, C.R., et al. Drug-eluting stents vs coronary-artery bypass grafting in multivessel coronary disease. N Engl J Med 358 (2008), 331–341.
3. Abdallah, M.S., Wang, K., Magnuson, E.A., Spertus, J.A., Farkouh, M.D., Fuster, V., et al. Quality of life after PCI vs CABG among patients with diabetes and multivessel coronary artery disease: a randomized clinical trial. JAMA 310 (2013), 1581–1590.
4. Hogue, C.W. Jr., Palin, C.A., Arrowsmith, J.E., Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices. Anesth Analg 103 (2006), 21–37.
5. Murkin, J.M., Farrar, J.K., Tweed, W.A., McKenzie, F.N., Guiraudon, G., Cerebral autoregulation and flow/metabolism coupling during cardiopulmonary bypass: the influence of PaCO2. Anesth Analg 66 (1987), 825–832.
6. Schell, R.M., Kern, F.H., Greeley, W.J., Schulman, S.R., Frasco, P.E., Croughwell, N.D., et al. Cerebral blood flow and metabolism during cardiopulmonary bypass. Anesth Analg 76 (1993), 849–865.
7. Taylor, K.M., The hemodynamics of cardiopulmonary bypass. Semin Thorac Cardiovasc Surg 2 (1990), 300–312.
8. Yamamoto, M., Meyer, J.S., Sakai, F., Yamaguchi, F., Aging and cerebral vasodilator responses to hypercarbia: responses in normal aging and in persons with risk factors for stroke. Arch Neurol 37 (1980), 489–496.
9. Schoof, J., Lubahn, W., Baeumer, M., Kross, R., Wallesch, C.W., Kozian, A., et al. Impaired cerebral autoregulation distal to carotid stenosis/occlusion is associated with increased risk of stroke at cardiac surgery with cardiopulmonary bypass. J Thorac Cardiovasc Surg 134 (2007), 690–696.
10. Inouye, S.K., Delirium in older persons. N Engl J Med 354 (2006), 1157–1165.
11. Moraca, R., Lin, E., Holmes, J.H.T., Fordyce, D., Campbell, W., Ditkoff, M., et al. Impaired baseline regional cerebral perfusion in patients referred for coronary artery bypass. J Thorac Cardiovasc Surg 131 (2006), 540–546.
12. Gottesman, R.F., Sherman, P.M., Grega, M.A., Yousem, D.M., Borowicz, L.M. Jr, Selnes, O.A., et al. Watershed strokes after cardiac surgery: diagnosis, etiology, and outcome. Stroke 37 (2006), 2306–2311.
13. Gottesman, R.F., Hillis, A.E., Grega, M.A., Borowicz, L.M. Jr, Selnes, O.A., Baumgartner, W.A., et al. Early postoperative cognitive dysfunction and blood pressure during coronary artery bypass graft operation. Arch Neurol 64 (2007), 1111–1114.
14. Floyd, T.F., Harris, F., McGarvey, M., Detre, J.A., Recurrence of stroke after cardiac surgery: insight into pathogenesis via diffusion-weighted and continuous arterial spin labeling perfusion magnetic resonance imaging. J Cardiothorac Vasc Anesth 21 (2007), 106–109.
15. Czosnyka, M., Brady, K., Reinhard, M., Smielewski, P., Steiner, L.A., Monitoring of cerebrovascular autoregulation: facts, myths, and missing links. Neurocrit Care 10 (2009), 373–386.
16. Joshi, B., Ono, M., Brown, C., Brady, K., Easley, R.B., Yenokyan, G., et al. Predicting the limits of cerebral autoregulation during cardiopulmonary bypass. Anesth Analg 114 (2012), 503–510.
17. Brady, K., Joshi, B., Zweifel, C., Smielewski, P., Czosnyka, M., Easley, R.B., et al. Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass. Stroke 41 (2010), 1951–1956.
18. Ono, M., Arnaoutakis, G.J., Fine, D.M., Brady, K., Easley, R.B., Zheng, Y., et al. Blood pressure excursions below the cerebral autoregulation threshold during cardiac surgery are associated with acute kidney injury. Crit Care Med 41 (2013), 464–471.
19. Ono, M., Brady, K., Easley, R.B., Brown, C., Kraut, M., Gottesman, R.F., et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg 147 (2014), 483–489.
20. Hori, D., Brown, C., Ono, M., Rappold, T., Sieber, F., Gottschalk, A., et al. Arterial pressure above the upper cerebral autoregulation limit during cardiopulmonary bypass is associated with postoperative delirium. Br J Anaesth 113 (2014), 1009–1017.
21. Ono, M., Joshi, B., Brady, K., Easley, R.B., Zheng, Y., Brown, C., et al. Risks for impaired cerebral autoregulation during cardiopulmonary bypass and postoperative stroke. Br J Anaesth 109 (2012), 391–398.
22. Aries, M.J., Czosnyka, M., Budohoski, K.P., Steiner, L.A., Lavinio, A., Kolias, A.G., et al. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit Care Med 40 (2012), 2456–2463.
23. Brady, K.M., Mytar, J.O., Lee, J.K., Cameron, D.E., Vricella, L.A., Thompson, W.R., et al. Monitoring cerebral blood flow pressure autoregulation in pediatric patients during cardiac surgery. Stroke 41 (2010), 1957–1962.
24. Ono, M., Zheng, Y., Joshi, B., Sigl, J.C., Hogue, C.W., Validation of a stand-alone near-infrared spectroscopy system for monitoring cerebral autoregulation during cardiac surgery. Anesth Analg 116 (2013), 198–204.
25. McKhann, G.M., Grega, M.A., Borowicz, L.M. Jr., Baumgartner, W.A., Selnes, O.A., Stroke and encephalopathy after cardiac surgery: an update. Stroke 37 (2006), 562–571.
26. Steiner, L.A., Czosnyka, M., Piechnik, S.K., Smielewski, P., Chatfield, D., Menon, D.K., et al. Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med, 2002, 733–738.
27. Steiner, L., Coles, J., Johnston, A., Chatfield, D.A., Smielewski, P., Fryer, T.D., et al. Assessment of cerebrovascular autoregulation in head-injured patients: a validation study. Stroke 34 (2003), 2404–2409.
28. Brady, K.M., Lee, J.K., Kibler, K.K., Smielewski, P., Czosnyka, M., Easley, R.B., et al. Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy. Stroke 38 (2007), 2818–2825.
29. Govier, A.V., Reves, J.G., McKay, R.D., Karp, R.B., Zorn, G.L., Morawetz, R.B., et al. Factors and their influence on regional cerebral blood flow during nonpulsatile cardiopulmonary bypass. Ann Thorac Surg 38 (1984), 592–600.
30. Hori, D., Ono, M., Rappold, T.E., Conte, J.V., Shah, A.S., Cameron, D.E., et al. Hypotension after cardiac operations based on autoregulation monitoring leads to brain cellular injury. Ann Thorac Surg 100 (2015), 487–493.
31. Levy, J.H., Tanaka, K.A., Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg 75 (2003), S715–S720.
32. Rafiq, M.K., Connolly, D., Randall, M., Blank, C., Cerebral hyperperfusion syndrome. Pract Neurol 14 (2014), 64–66.
33. Schwartz, R.B., Hyperperfusion encephalopathies: hypertensive encephalopathy and related conditions. Neurologist 8 (2002), 22–34.
34. Pfister, D., Siegemund, M., Dell-Kuster, S., Smielewski, P., Rüeggg, S., Strebel, S.P., et al. Cerebral perfusion in sepsis-associated delirium. Crit Care, 12, 2008, R63.
35. Sorrentino, E., Budohoski, K.P., Kasprowicz, M., Budohoski, K.P., Haubrich, C., Smielewski, P., et al. Critical thresholds for transcranial Doppler indices of cerebral autoregulation in traumatic brain injury. Neurocrit Care 14 (2011), 188–193.
36. Steiner, L., Coles, J., Johnston, A., Chatfield, D., Smielewski, P., Fryer, T., et al. Assessment of cerebrovascular autoregulation in head-injured patients: a validation study. Stroke 34 (2003), 2404–2409.
37. Lang, E.W., Mehdorn, H.M., Dorsch, N.W., Czosnyka, M., Continuous monitoring of cerebrovascular autoregulation: a validation study. J Neurol Neurosurg Psychiatry 72 (2002), 583–586.
38. Steiner, L.A., Czosnyka, M., Piechnik, S.K., Smielewski, P., Chatfield, D., Menon, D.K., et al. Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med 30 (2002), 733–738.
39. Reinhard, M., Roth, M., Muller, T., Guschlbauer, B., Timmer, J., Czosnyka, M., et al. Effect of carotid endarterectomy or stenting on impairment of dynamic cerebral autoregulation. Stroke 35 (2004), 1381–1387.
40. Minhas, P.S., Smielewski, P., Kirkpatrick, P.J., Pickard, J.D., Czosnyka, M., Pressure autoregulation and positron emission tomography-derived cerebral blood flow acetazolamide reactivity in patients with carotid artery stenosis. Neurosurgery 55 (2004), 63–68.
41. Reinhard, M., Roth, M., Guschlbauer, B., Harloff, A., Timmer, J., Czosnyka, M., et al. Dynamic cerebral autoregulation in acute ischemic stroke assessed from spontaneous blood pressure fluctuations. Stroke 36 (2005), 1684–1689.
42. Lavinio, A., Schmidt, E., Haubrich, C., Smielewski, P., Pickard, J.D., Czosnyka, M., Noninvasive evaluation of dynamic cerebrovascular autoregulation using Finapres plethysmograph and transcranial Doppler. Stroke 38 (2007), 402–404.
43. Brady, K.M., Lee, J.K., Kibler, K.K., Smielewski, P., Czosnyka, M., Easley, R.B., et al. Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy. Stroke 38 (2007), 2818–2825.
44. Brady, K., Joshi, B., Zweifel, C., Smielewski, P., Czosnyka, M., Easley, B., et al. Real time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass. Stroke 41 (2010), 1951–1956.
45. Blauth, C., Schulenberg, W., McCartney, A., Taylor, K., Loop, F., Retinal microvascular studies in vivo with fluorescein angiography. J Thorac Cardiovasc Surg 95 (1988), 668–676.
46. Schell, R., Kern, F., Greeley, W., Schulman, S., Frasco, P., Croughwell, N., et al. Cerebral blood flow and metabolism during cardiopulmonary bypass. Anesth Analg 76 (1993), 849–865.
47. Ono, M., Arnaoutakis, G.J., Fine, D.M., Brady, K., Easley, R.B., Zheng, Y., et al. Blood pressure excursions below the cerebral autoregulation threshold during cardiac surgery are associated with acute kidney injury. Crit Care Med 41 (2013), 464–471.
48. Ono, M., Brady, K., Easley, R., Brown, C., Kraut, M., Gottesman, R., et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. J Thorac Cardiovasc Surg 147 (2014), 483–489.