Mean arterial pressure difference before and during cardiopulmonary bypass: what should be the ideal mean perfusion...

The difference between mean arterial pressure (MAP) before cardiopulmonary bypass (CPB) and mean perfusion pressure (MPP) during CPB is thought to be a strong predictor of acute kidney injury (AKI). In this study, we aimed to evaluate whether the difference between MAP and MPP is a good index to predict the development of AKI and what the ideal MPP should be during CPB.

A total of 296 consecutive patients were included in this retrospective study. MAP-MPP differences of patients who developed AKI and those who did not develop AKI according to standard guidelines and their relation with adverse outcomes were evaluated.

MAP values of patients who did not develop AKI and patients who developed AKI were higher in the group with AKI, 67.60 mmHg versus 64.84 mmHg (p = 0.001). The MAP-MPP difference was 5.07 in the group without AKI and 9.44 in the group with AKI (p = 0.000).

We found that the difference between MAP and MPP is a good index for predicting the development of CPB-related AKI and poor outcomes. We also suggest that patients' preoperative arterial blood pressure should be taken into account for an ideal MPP.