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Updated: Aug 6, 2025

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
08:12

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS

Published on: November 26, 2018

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Perioperative individualized hemodynamic optimization according to baseline mean arterial pressure in cardiac surgery

Richard Descamps1, Julien Amour2, Emmanuel Besnier3

  • 1Department of Anesthesiology and Critical Care Medicine, Caen University Hospital, Caen, France.

American Heart Journal
|March 19, 2023
PubMed

Insights

Optimizing mean arterial pressure (MAP) to a patient’s baseline during and after cardiac surgery may reduce postoperative complications. The OPTIPAM trial investigates this individualized MAP approach versus a fixed MAP target to improve patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Critical Care Medicine

Background:

  • Postoperative morbidity and mortality after cardiac surgery with cardiopulmonary bypass (CPB) remain high.
  • Optimal arterial pressure management is a modifiable risk factor for postoperative complications.
  • Individualizing mean arterial pressure (MAP) to a patient's baseline may improve outcomes.

Purpose of the Study:

  • To test the superiority of optimized MAP management compared to a fixed MAP target in patients undergoing cardiac surgery with CPB.
  • To evaluate the effectiveness of individualized MAP targeting in reducing postoperative morbidity and mortality.

Main Methods:

  • Multicenter, randomized, open-label controlled trial (OPTIPAM trial, NCT05403697).
  • 1,100 patients scheduled for cardiac surgery with CPB.
  • Comparison between optimized MAP (patient baseline) and MAP ≥ 65 mm Hg during intraoperative and postoperative periods.

Main Results:

  • Primary composite endpoint: acute kidney injury, neurological complications (stroke, delirium), and death.
  • Secondary endpoints: hospital/ICU length of stay, mortality at Day 7 and Day 90, cognitive dysfunction, and quality of life.
  • Two interim analyses to assess intervention safety.

Conclusions:

  • The OPTIPAM trial will assess the effectiveness of individualized mean arterial pressure targets in cardiac surgery with CPB.
  • The study aims to reduce postoperative complications by optimizing MAP to patient baseline.
  • Findings may inform future guidelines for perioperative hemodynamic management.
Abstract

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