Impact of Intraoperative Mean Arterial Pressure on Respiratory Recovery Following Coronary Artery Bypass Grafting

Abstract

Background: Coronary artery bypass graft (CABG) is a common surgery aimed at treating coronary artery disease. A vital aspect of CABG is managing hemodynamics during the cardiopulmonary bypass (CPB) phase, especially in terms of maintaining appropriate mean arterial pressure (MAP). Studies indicate that MAP levels during CPB can affect postoperative recovery, particularly regarding respiratory outcomes; however, the optimal MAP for enhanced recovery remains uncertain. This research examines the impact of two MAP targets (60 mmHg and 80 mmHg) on respiratory recovery after CABG surgery.
Methods: Eighty-six patients selected for elective on-pump CABG were grouped based on intraoperative MAP: 43 with a MAP of 60 mmHg and 43 with a MAP of 80 mmHg. We compared perioperative and postoperative metrics, such as mechanical ventilation duration, ICU stay, and re-intubation requirements. Statistical analysis used SPSS version 23, with a significance threshold of p < 0.05.
Results: Patients with a mean arterial pressure (MAP) of 80 mmHg experienced a significantly reduced duration of mechanical ventilation, averaging 8.23 ± 1.54 hours, in contrast to the 60 mmHg group, which averaged 10.02 ± 2.14 hours (p = 0.001). Additionally, the ICU stays were significantly shorter for the high MAP group, with a markedly lower re-intubation rate at 4.7%, compared to 27.9% in the lower MAP group (p = 0.007).
Conclusion: Sustaining a MAP of 80 mmHg during CPB enhances respiratory recovery after CABG. This is demonstrated by shorter mechanical ventilation durations and reduced ICU stays. These results indicate that effectively managing MAP during surgery could facilitate recovery by improving tissue perfusion and reducing ischemic injury, which in turn may lead to improved pulmonary outcomes