Associations between mean arterial pressure during cardiopulmonary bypass and biomarkers of cerebral injury in patients undergoing cardiac surgery: secondary results from a randomized controlled trial
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Associations between mean arterial pressure during cardiopulmonary bypass and biomarkers of cerebral injury in patients undergoing cardiac surgery : secondary results from a randomized controlled trial. / Wiberg, Sebastian; Holmgaard, Frederik; Blennow, Kaj; Nilsson, Jens C.; Kjaergaard, Jesper; Wanscher, Michael; Langkilde, Annika R.; Hassager, Christian; Rasmussen, Lars S.; Zetterberg, Henrik; Vedel, Anne Grønborg.
In: Interactive Cardiovascular and Thoracic Surgery, Vol. 32, No. 2, 2021, p. 229-235.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Associations between mean arterial pressure during cardiopulmonary bypass and biomarkers of cerebral injury in patients undergoing cardiac surgery
T2 - secondary results from a randomized controlled trial
AU - Wiberg, Sebastian
AU - Holmgaard, Frederik
AU - Blennow, Kaj
AU - Nilsson, Jens C.
AU - Kjaergaard, Jesper
AU - Wanscher, Michael
AU - Langkilde, Annika R.
AU - Hassager, Christian
AU - Rasmussen, Lars S.
AU - Zetterberg, Henrik
AU - Vedel, Anne Grønborg
PY - 2021
Y1 - 2021
N2 - OBJECTIVES: Cardiac surgery is associated with risk of cerebral injury and mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) is suggested to be associated with cerebral injury. The 'Perfusion Pressure Cerebral Infarcts' (PPCI) trial randomized patients undergoing coronary artery bypass grafting (CABG) and/or aortic valve replacement to a MAP of 40-50 or 70-80 mmHg during CPB and found no difference in clinical or imaging outcomes between the groups. We here present PPCI trial predefined secondary end points, consisting of biomarkers of brain injury. METHODS: Blood was collected from PPCI trial patients at baseline, 24 and 48 h after induction of anaesthesia and at discharge from the surgical ward. Blood was analysed for neuron-specific enolase, tau, neurofilament light and the glial marker glial fibrillary acidic protein. Linear mixed models were used to analyse differences in biomarker value changes from baseline between the 2 MAP allocation groups. RESULTS: A total of 193 (98%) patients were included. We found no differences in biomarker levels over time from baseline to discharge between the 2 MAP allocation groups (PNSE = 0.14, PTau = 0.46, PNFL = 0.21, PGFAP = 0.13) and the result did not change after adjustment for age, sex and type of surgery. CONCLUSIONS: We found no significant differences in levels of biomarkers of neurological injury in patients undergoing elective or subacute CABG and/or aortic valve replacement randomized to either a target MAP of 40-50 mmHg or a target MAP of 70-80 mmHg during CBP.
AB - OBJECTIVES: Cardiac surgery is associated with risk of cerebral injury and mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) is suggested to be associated with cerebral injury. The 'Perfusion Pressure Cerebral Infarcts' (PPCI) trial randomized patients undergoing coronary artery bypass grafting (CABG) and/or aortic valve replacement to a MAP of 40-50 or 70-80 mmHg during CPB and found no difference in clinical or imaging outcomes between the groups. We here present PPCI trial predefined secondary end points, consisting of biomarkers of brain injury. METHODS: Blood was collected from PPCI trial patients at baseline, 24 and 48 h after induction of anaesthesia and at discharge from the surgical ward. Blood was analysed for neuron-specific enolase, tau, neurofilament light and the glial marker glial fibrillary acidic protein. Linear mixed models were used to analyse differences in biomarker value changes from baseline between the 2 MAP allocation groups. RESULTS: A total of 193 (98%) patients were included. We found no differences in biomarker levels over time from baseline to discharge between the 2 MAP allocation groups (PNSE = 0.14, PTau = 0.46, PNFL = 0.21, PGFAP = 0.13) and the result did not change after adjustment for age, sex and type of surgery. CONCLUSIONS: We found no significant differences in levels of biomarkers of neurological injury in patients undergoing elective or subacute CABG and/or aortic valve replacement randomized to either a target MAP of 40-50 mmHg or a target MAP of 70-80 mmHg during CBP.
KW - Aortic valve replacement
KW - Biomarkers
KW - Coronary artery bypass grafting
KW - Neurological injury
U2 - 10.1093/icvts/ivaa264
DO - 10.1093/icvts/ivaa264
M3 - Journal article
C2 - 33221914
AN - SCOPUS:85100359318
VL - 32
SP - 229
EP - 235
JO - Interactive Cardiovascular and Thoracic Surgery
JF - Interactive Cardiovascular and Thoracic Surgery
SN - 1569-9293
IS - 2
ER -
ID: 256984214