• J. Cardiothorac. Vasc. Anesth. · Feb 2024

    Pro: Individualized Optimal Perfusion Pressure- Maximizing Patient Care During Cardiopulmonary Bypass.

    • Rushil Vladimir Ramachandran and Balachundhar Subramaniam.
    • Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA.
    • J. Cardiothorac. Vasc. Anesth. 2024 Feb 1; 38 (2): 563565563-565.

    AbstractCardiopulmonary bypass (CPB) has revolutionized cardiac surgery but poses challenges such as hemodynamic instability and adverse clinical outcomes. Achieving optimal perfusion during CPB ensures adequate oxygen delivery to vital organs. Although mean arterial pressure is a key determinant of perfusion pressure, clear guidelines for optimal perfusion have yet to be established. Autoregulation, the organ's ability to maintain consistent blood flow, plays a vital role in perfusion. Individual variability in autoregulation responses and intraoperative factors necessitate an individualized approach to determining the autoregulation range. Continuous assessment of autoregulation during surgery allows for personalized perfusion targets, optimizing organ perfusion. Exploring techniques like multimodal intravenous anesthesia guided by electroencephalogram can enhance perfusion maintenance within the auto-regulatory range. By adopting an individualized approach to perfusion targets on CPB, we can improve outcomes and enhance patient care.Copyright © 2023 Elsevier Inc. All rights reserved.

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