The Conundrum of Systemic Arterial Pressure Management on Cardiopulmonary Bypass.

The recently released EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass (CPB) in adult cardiac surgery [[1]] address, within the general topic, the management of systemic arterial pressure (SAP) during CPB. Basic Physiology of SAP during CPB The majority of CPB surgeries are presently managed with nonpulsatile flow. Hyperlactatemia during CPB has been associated with a number of negative outcomes [[26]], and although an inadequate MAP could be only one of the possible reasons for hyperlactatemia, the effects of different MAP regimens on arterial blood lactates deserve attention. Some of these studies investigated the effects of different MAPs before, during, and after CPB [[16]], but the majority addressed only different MAP regimens during CPB. [Extracted from the article]