High Versus Normal Blood Pressure Targets in Relation to Right Ventricular Dysfunction After Cardiac Surgery: A Randomized Controlled Trial

Bootsma, Inge T.; Lange, Fellery de; Scheeren, Thomas; Jainandunsing, Jayant S.; Boerma, E. Christiaan

doi:10.1053/j.jvca.2021.02.054

Cited by 2 publications

(1 citation statement)

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“…Consequently, those with significant right ventricular dysfunction, including those post-orthotopic heart transplantation, will require higher MAP goals. 23 Other specific populations that may benefit from higher MAP goals include patients with coronary air embolism during weaning from CPB, 24 patients with a prolonged CPB run or cross-clamp time, and those who have difficulty weaning from CPB, which may be associated with relative coronary ischemia. Finally, poor perioperative urine output may indicate end-organ hypoperfusion and increased risk of acute kidney injury, so such patients may benefit from higher perfusion pressure.…”

Section: Cardiac Critical Care: Different Patient Populations and Per...mentioning

confidence: 99%

Blood Pressure Goals in Critically Ill Patients

Rajkumar¹,

Hicks²,

Marchant

et al. 2023

Methodist DeBakey Cardiovascular Journal

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Blood pressure goals in the intensive care unit (ICU) have been extensively investigated in large datasets and have been associated with various harm thresholds at or greater than a mean pressure of 65 mm Hg. While it is difficult to perform interventional randomized trials of blood pressure in the ICU, important evidence does not support defense of a higher pressure, except in retrospective database analyses. Perfusion pressure may be a more important target than mean pressure, even more so in the vulnerable patient population. In the cardiac ICU, blood pressure targets are tailored to specific cardiac pathophysiology and patient characteristics. Generally, the goal is to maintain adequate blood pressure within a certain range to support cardiac function and to ensure end organ perfusion. Individualized targets demand the use of both invasive and noninvasive monitoring modalities and frequent titration of medications and/or mechanical circulatory support where necessary. In this review, we aim to identify appropriate blood pressure targets in the ICU, recognizing special patient populations and outlining the risk factors and predictors of end organ failure.

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Section: Cardiac Critical Care: Different Patient Populations and Per...mentioning

confidence: 99%