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MECHANISM OF INJURY, ASSOCIATED OUTCOME AND INTERVENTION

Learn more about hypotension causing cerebral desaturation:

Mechanism of Injury

  • Once mean arterial pressure moves outside the threshold of autoregulation, cerebral perfusion becomes dependent on blood pressure. In patients undergoing cardiopulmonary bypass, the lower limit of autoregulation can vary widely, from 40 to 90 mmHg1
  • In circumstances where cerebral perfusion is dependent on blood pressure, it is increasingly likely for even mild hypotension to cause hypoperfusion and ischemia2

Associated Outcome

  • Gottesman et.al found that an intraoperative mean arterial pressure decrease of >= 10 mmHg from preoperative baseline increased the likelihood of watershed stroke 4.1 times3
Intervention % of all interventions4
Adjust mean arterial pressure 34.2

MECHANISM OF INJURY, ASSOCIATED OUTCOME AND INTERVENTION

Learn more about hypotension causing cerebral desaturation:

Mechanism of Injury

  • Once mean arterial pressure moves outside the threshold of autoregulation, cerebral perfusion becomes dependent on blood pressure. In patients undergoing cardiopulmonary bypass, the lower limit of autoregulation can vary widely, from 40 to 90 mmHg1
  • In circumstances where cerebral perfusion is dependent on blood pressure, it is increasingly likely for even mild hypotension to cause hypoperfusion and ischemia2

Associated Outcome

  • Gottesman et.al found that an intraoperative mean arterial pressure decrease of >= 10 mmHg from preoperative baseline increased the likelihood of watershed stroke 4.1 times3
Intervention % of all interventions4
Adjust mean arterial pressure 34.2

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  • 1. Joshi B, Ono M, Brown C, et al. Predicting the limits of cerebral autoregulation during cardiopulmonary bypass. Anesthesia and analgesia. 2012;114(3):503-510.
  • 2. Ono M, Brady K, Easley RB, et al. Duration and magnitude of blood pressure below cerebral autoregulation threshold during cardiopulmonary bypass is associated with major morbidity and operative mortality. The Journal of thoracic and cardiovascular surgery. 2014;147(1):483-489.
  • 3. Gottesman RF, Sherman PM, Grega MA, et al. Watershed strokes after cardiac surgery: diagnosis, etiology, and outcome. Stroke. 2006;37(9):2306-2311.  View Abstract
  • 4. Deschamps A, Lambert J, Couture P, et al. Reversal of decreases in cerebral saturation in high-risk cardiac surgery. Journal of cardiothoracic and vascular anesthesia. 2013;27(6):1260-1266. View Abstract
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