Document Detail


Perioperative blood pressure control: a prospective survey of patient management in cardiac surgery.
MedLine Citation:
PMID:  10890479     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To conduct a survey of current cardiac anesthetic practice in Europe and the United States, as a first step toward establishing guidelines for the management of perioperative hypertension. DESIGN: Prospective, multicenter study. SETTING: University hospitals. PARTICIPANTS: Unselected patients (n = 1,930) requiring cardiac surgery. INTERVENTIONS: Data extending from the preoperative evaluation to 120 hours or more after surgery were collected from all patients. MEASUREMENTS AND MAIN RESULTS: Only the data from patients undergoing coronary artery bypass surgery, valve surgery, or combined procedures were analyzed, leaving a final total of 1,660 patients from the original 1,930. Of these, 88% were treated at least once perioperatively to lower arterial blood pressure. Deepening of anesthesia was the most commonly used antihypertensive measure (68%), regardless of the ongoing anesthetic regimen, and was usually combined with vasodilator therapy, most frequently nitroglycerin (53%) or sodium nitroprusside (28%). Reported perioperative mean arterial pressure (MAP) was 15 to 20 mmHg lower than MAP before anesthesia induction, regardless of the use of antihypertensive therapy. The MAP at which antihypertensive treatment was initiated varied markedly among the various phases of surgery and showed no clear correlation with preoperative MAP. CONCLUSIONS: The results of this survey show that current anesthetic practice tries to prevent perioperative hypertension wherever possible during cardiac surgery. Blood pressure measurements taken before surgery have little influence on the development of hypertension intraoperatively, and the main determinants of perioperative blood pressure control and the need for therapeutic intervention are factors arising from the surgical procedure itself, such as aortic cross-clamping and activation of adrenergic mechanisms.
Authors:
A Vuylsteke; R O Feneck; A Jolin-Mellgård; R D Latimer; J H Levy; C Lynch; M L Nordlander; P Nyström; S E Ricksten
Related Documents :
20528389 - Pharmacoeconomics and quality of life analysis of telmisartan in hypertension treatment.
21046489 - Dual-acting angiotensin receptor-neprilysin inhibition.
16180959 - Uncontrolled blood pressure in a treated, high-risk managed care population.
9540129 - Vascular remodeling and endothelial function in hypertensive patients: effects of antih...
15202749 - The new blood pressure guidelines: a digest.
17184139 - Systolic hypertension.
19301939 - Relationship between decrease in ambulatory blood pressure and heart rate variability d...
7032259 - Direct effects of endotoxin on the microcirculation.
24105309 - Idiopathic normal pressure hydrocephalus: an important differential diagnosis.
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  14     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-10-26     Completed Date:  2000-10-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  269-73     Citation Subset:  IM    
Affiliation:
Department of Anesthesia, Papworth Hospital, Cambridge, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Blood Pressure*
Coronary Artery Bypass*
Heart Valves / surgery*
Humans
Hypertension / drug therapy*,  physiopathology
Prospective Studies

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


Previous Document:  Volume therapy with a new hydroxyethyl starch solution in cardiac surgical patients before cardiopul...
Next Document:  Femoral artery pressures are more reliable than radial artery pressures on initiation of cardiopulmo...