Targeting MAP during CPB reduces postop delirium

Editor's Note

Targeting a patient’s mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) by monitoring cerebral blood flow autoregulation may reduce the incidence of delirium after cardiac surgery in older patients, this Johns Hopkins study finds.

In this analysis of 199 patients, the incidence of delirium was significantly greater in patients given usual care (53%) than in those in which MAP was targeted using cerebral autoregulation monitoring (38%).

The findings suggest that optimizing MAP to be greater than the patient’s lower limit of cerebral blood flow autoregulation during CPB may reduce delirium after cardiac surgery, the authors say. The results should be confirmed in a multicenter study, and the benefit of extending the monitoring throughout surgery or ICU requires further research.