Document Detail


Improvement of outcomes after coronary artery bypass II: a randomized trial comparing intraoperative high versus customized mean arterial pressure.
MedLine Citation:
PMID:  18039205     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: The objective of this randomized trial was to compare the efficacy of two strategies of hemodynamic management during cardiopulmonary bypass (CPB) on morbidity, mortality, cognitive complications and deterioration in functional status. METHODS: Patients scheduled to undergo primary elective CABG were eligible. In one group, mean arterial pressure target during CPB was 80 mmHg ("high" MAP group); in the other group, MAP target was determined by patients' pre-bypass MAP ("custom" MAP group). The principal outcomes were mortality, major neurologic or cardiac complications, cognitive complications or deterioration in functional status. RESULTS: Of 412 enrolled patients, 36% were women, with overall mean age of 64.7 +/- 12.3 years. Duration of bypass was identical for the two randomization groups. Overall complication rates were similar: 16.5% of the high group and 14.6% of the custom group experienced one or more neurologic, cardiac or cognitive complications. When only cardiac and neurologic morbidity and mortality were considered, the rates were 11.7% and 12.6%, in the high and custom groups, respectively. The aggregate outcome rate, including functional deterioration, was 31.6% in the high group and 29.6% in the custom group. CONCLUSIONS: There were no statistically significant differences between the high MAP group and the custom MAP group for the combined outcome of mortality cardiac, neurologic or cognitive complications, and deterioration in the quality of life.
Authors:
Mary E Charlson; Janey C Peterson; Karl H Krieger; Gregg S Hartman; James P Hollenberg; William M Briggs; Alan Z Segal; Manish Parikh; Stephen J Thomas; Rebecca G Donahue; Mary Helen Purcell; Paul A Pirraglia; O Wayne Isom
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  22     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-11-27     Completed Date:  2008-02-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  465-72     Citation Subset:  IM    
Affiliation:
Cornell Coronary Artery Bypass Outcomes Trial Group, Department of Medicine, Weill Cornell Medical College, New York, USA. mecharl@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure
Cardiopulmonary Bypass
Cognition
Cognition Disorders / etiology
Coronary Artery Bypass / adverse effects*
Coronary Artery Disease / surgery*
Female
Humans
Male
Middle Aged
Nervous System Diseases / etiology
Postoperative Complications
Postoperative Period
Risk Factors
Time Factors
Treatment Outcome*
Grant Support
ID/Acronym/Agency:
HL44719/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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