Background: Rewarming on cardiopulmonary bypass (CPB) is associated with increased metabolic demands; however, it remains unclear whether cerebral autoregulation is affected during this phase. This RCT aims to describe the effects of 20% supranormal, compared to normal CPB flow, on monitoring signs of inadequate perfusion, oxygenation, and disturbed cerebral autoregulation, during the rewarming phase of CPB.
Method: Thirty two patients scheduled for coronary artery bypass grafting were allocated to a Control group ( = 16) receiving a CPB pump flow corresponding to preoperatively measured cardiac output, and an Intervention group ( = 16) receiving the corresponding CPB pump flow increased by 20% during rewarming. Cerebral Oximetry Index (COx) was calculated with the aid of Near Infrared Spectroscopy.
Results: Twenty five patients were included in the data. Results show a median COx value of 0.0 (IQR -0.33-0.5) (Control) and 0.0 (IQR -0.15-0.25) (Intervention), respectively; = .85 with individual variations within groups. The median cerebral perfusion pressure (CPP) was 55 (52-58) (Control) and 61 (54-66) mmHg (Intervention); = .08. No significant difference in rSO2 values was observed between the groups (58.5% (50-61) versus 64% (58-68); = .06).
Conclusion: The present study showed no difference between increased and normal CPB pump flow with respect to cerebral autoregulation during rewarming. Large variations in cerebral autoregulation were seen at individual level.
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| http://dx.doi.org/10.1177/02676591211064961 | DOI Listing |
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