Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after Noncardiac Surgery

• DOI: 10.1097/aln.0b013e3182a10e26
• Publication Date: 2013-07-04T18:35:53Z
• Authors: Michael Walsh; Philip J. Devereaux; Amit X. Garg; Andrea Kurz; Alparslan Turan; Reitze N. Rodseth; Jacek Cywinski; Lehana Thabane; Daniel I. Sessler
• Keywords: Mean arterial pressure

Abstract Background: Intraoperative hypotension may contribute to postoperative acute kidney injury (AKI) and myocardial injury, but what blood pressures are unsafe is unclear. The authors evaluated the association between intraoperative mean arterial pressure (MAP) risk of AKI injury. Methods: obtained perioperative data for 33,330 noncardiac surgeries at Cleveland Clinic, Ohio. MAP from less than 55 75 mmHg determine threshold where increased. then duration below this their outcomes adjusting potential confounding variables. Results: developed in 2,478 (7.4%) 770 (2.3%) surgeries, respectively. both increased was mmHg. Compared with never developing a mmHg, those 1–5, 6–10, 11–20, more 20 min had graded increases two (AKI: 1.18 [95% CI, 1.06–1.31], 1.19 [1.03–1.39], 1.32 [1.11–1.56], 1.51 [1.24–1.84], respectively; 1.30 [1.06–1.5], 1.47 [1.13–1.93], 1.79 [1.33–2.39], 1.82 [1.31–2.55], respectively]. Conclusions: Even short durations an associated Randomized trials required whether improve interventions that maintain least