• Vincent Bouchard-Dechêne, Pierre Couture, Antonio Su, Alain Deschamps, Yoan Lamarche, Georges Desjardins, Sylvie Levesque, and André Y Denault.
• Department of Anesthesiology, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
• J. Cardiothorac. Vasc. Anesth. 2018 Apr 1; 32 (2): 692-698.

ObjectiveTo identify risk factors associated with radial-to-femoral pressure gradient during cardiac surgery with cardiopulmonary bypass (CPB).DesignThis is a retrospective, observational study.SettingSingle specialized cardiothoracic hospital in Montreal, Canada.ParticipantsConsecutive patients that underwent heart surgery with CPB between 2005 and 2015 (n = 435).InterventionsNone.Measurements And Main ResultsA radial-to-femoral pressure gradient occurred in 146 patients of the 435 patients (34%). Based on the 10,000 bootstrap samples, simple logistic regression models identified the 17 most commonly significant variables across the bootstrap runs. Using these variables, a backward multiple logistic model was performed on the original sample and identified the following independent variables: body surface area (m2) (odds ratio [OR] 0.08, 95% confidence interval [CI] 0.030-0.232), clamping time (minutes) (OR 1.01, 95% CI 1.007-1.018), fluid balance (for 1 liter) (OR 0.81, 95% CI 0.669-0.976), and preoperative hypertension (OR 1.801, 95% CI 1.131-2.868).ConclusionA radial-to-femoral pressure gradient occurs in 34% of patients during cardiac surgery. Patients at risk seem to be of smaller stature, hypertensive, and undergo longer and more complex surgeries.Copyright © 2017 Elsevier Inc. All rights reserved.

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