MEAN ARTERIAL PRESSURE AND PULSE PRESSURE, INFLUENCE ON POSTOPERATIVE RENAL AND NEUROLOGICAL OUTCOMES IN ELDERLY PATIENTS UNDERGOING CORONARY REVASCULARIZATION

Abstract

Objectives: To observe the impact of bothMAPand PP for the postoperative renaland neurological outcomes in patients undergoing CABG.

Methodology: This prospective double blinded observational study of patientsundergoing CABG, at Cardiac Surgery department, Punjab Institute of Cardiology,Lahore Pakistan, was conducted from January 2011 to November 2011.Preoperatively urea, creatinine, ultrasound kidney, X-Ray abdomen and CarotidDoppler study was performed. Postoperatively RIFLE criteria was used for AcuteRenal Injury. Patients with neurological deficit and seizures underwent CT andEEG. Data was analyzed by using SPSS 20. P 0.05 was considered assignificant.

Results: Total number of patients included were 115. Co morbid conditions foundin patients with high MAP and PP were hypertension (34.8%; p=0.612),diabetes mellitus (39.1%; p=0.305), obesity (65.2%; p= 0.001) and COPD(21.7%; p=0.001). Acute Kidney injury was in patients with pulse pressurebetween 31-40 mmHg & mean arterial pressure between 71-90 mmHg. The onlyassociation of ARI was found with hypertension (p=0.050). Stroke, RIND, TIA,coma and seizures had no association with pulse pressure <30mmHg and Meanarterial pressure of <70mmHg.

Conclusion: For post CABG patients MAP and PP are good markers for theneurological deficit but not for renal disease.