| Improvement of outcomes after coronary artery bypass II: a randomized trial comparing intraoperative high versus customized mean arterial pressure. | |
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MedLine Citation:
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PMID: 18039205 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 22 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2007 Nov-Dec |
Date Detail:
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Created Date: 2007-11-27 Completed Date: 2008-02-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 465-72 Citation Subset: IM |
Affiliation:
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Cornell Coronary Artery Bypass Outcomes Trial Group, Department of Medicine, Weill Cornell Medical College, New York, USA. mecharl@med.cornell.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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HL44719/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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