Central-radial artery pressure gradient after cardiopulmonary bypass is associated with cardiac function and may affect therapeutic direction.

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  • Author(s): Sun J;Sun J; Ding Z; Qian Y; Peng YG
  • Source:
    PloS one [PLoS One] 2013 Jul 22; Vol. 8 (7), pp. e68890. Date of Electronic Publication: 2013 Jul 22 (Print Publication: 2013).
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Blood Pressure* ; Heart Function Tests*; Cardiopulmonary Bypass/*methods ; Radial Artery/*physiology; Female ; Femoral Artery/physiology ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Risk Factors ; Thoracic Surgery
    • Abstract:
      Objective: To investigate the risk factors involved in radial-femoral artery pressure gradient after cardiac surgery.
      Methods: In this retrospective study, we reviewed 412 cardiac surgeries with both femoral artery pressure and radial artery pressure monitoring before cardiopulmonary bypass. 138 patients had radial-femoral artery pressure gradient after cardiopulmonary bypass (group P) but 263 were not (group N). Their hemodynamic data and other demographic data were analyzed.
      Results: Phenylephrine usage was 1.7±1.1 mg in group N and 2.9±1.2 mg in group P (P<0.001). Total adrenaline usage was 229.2±116.9 µg in group N and 400.6±145.1 µg in group P (P<0.001). SBP gradient was -4±3, 14±9, 10±4, 0±11 mmHg in group P and -3±3, 0±1, -1±9, -6±4 mmHg in group N after induction, during discontinuation of CPB, at the end of surgery and 1 postoperative day respectively. DBP gradient was 3±3, -1±9, 4±5, 0±8 mmHg in group P and 3±3, 5±2, 7±5, 0±8 mmHg in group N after induction, during discontinuation of CPB, at the end of surgery and 1 postoperative day respectively. MAP gradient was 1±2, 4±6, 6±4, 0±8 mmHg in group P and 1±2, 3±1, 1±4, -2±5 mmHg in group N after induction, during discontinuation of CPB, at the end of surgery and 1 postoperative day respectively. Significant arterial pressure gradient emerged during discontinuation of CPB and at the end of surgery, which was more obvious in group P(P<0.01). CI was 2.0±0.3, 2.3±0.4,2.3±0.4, 2.2±0.4 L/min/m(2) in group P and 2.1±0.3, 2.8±0.5,2.8±0.5, 2.8±0.5 L/min/m(2) in group N at baseline, after discontinuation of CPB, at the end of surgery and the first postoperative day (P<0.001).
      Conclusion: Detecting the exact central artery pressure is most important when patients have artery pressure gradients after cardiac surgery. Use inotropic agents to improve cardiac output, avoiding excessive vasoconstriction might reduce artery pressure gradient.
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    • Publication Date:
      Date Created: 20130730 Date Completed: 20140224 Latest Revision: 20211021
    • Publication Date:
      20231215
    • Accession Number:
      PMC3718816
    • Accession Number:
      10.1371/journal.pone.0068890
    • Accession Number:
      23894368