Relationship between blood pressure stability and mortality in cardiac surgery patients: retrospective cohort study

What is new in hemodynamic monitoring and management?

“…In a retrospective cohort study, Yoon et al [ 4 ] investigated the relationship between intraoperative blood pressure stability and postoperative mortality in 1203 patients having cardiac surgery with cardiopulmonary bypass. The authors hypothesized that intraoperative blood pressure stability based on individual preoperative blood pressure measurements could predict postoperative mortality.…”

Blood pressure stability: a road to better outcomes

“…Patients with stable blood pressure can be identified if they have low blood pressure variability measured by; standard deviation, coefficient of variation, average real variability, or generalized average real variability. Nevertheless, in this issue, Yoon et al [3] calculated blood pressure stability using performance measurement of MAP (mean arterial pressure) using median performance error (MDPE) and median absolute performance error (MDAPE), and wobble, using preoperative blood pressure as a reference value. MDPE is a measure of bias, in this case how far the intraoperative blood pressure deviated from baseline blood pressure.…”

“…Yoon et al [3] evaluated the relationship between blood pressure stability and postoperative mortality in patients undergoing cardiac surgery requiring CPB (cardiopulmonary bypass). The intraoperative invasive MAP was obtained from the electronic patient medical records every 2.5 min.…”

“…Measuring deviation of blood pressure from the baseline is different from previously reported methods of blood pressure variability which do not depend on baseline blood pressure. It can be argued that Yoon et al [3] measured the relationship between tight blood pressure control from baseline and postoperative mortality. Actual measure of blood pressure variability is coefficient of variance.…”

“…One other key difference is sampling rate, how often the blood pressure was measured and analyzed. Despite availability of continuous invasive blood pressure Yoon et al [3] used one reading in 2.5 min, compared to every 15 s, which can affect the measure of blood pressure variability.…”