Cerebral Oxygenation-Guided Indexed-Flow Normothermic Cardiopulmonary Bypass with Vasopressor-Sparing Pressure Management: A Retrospective Descriptive Cohort Study
- 1Department of Anesthesiology and Intensive, Botkin Hospital, Moscow, Russia
- 2Department of Cardiac Surgery, Botkin Hospital, Moscow, Russia
Abstract
Context:: Mean arterial pressure targets during cardiopulmonary bypass remain debated; vasopressor-driven pressure augmentation may not improve oxygen delivery.
Aims:: The aim of the paper is to describe clinical outcomes and physiologic markers during normothermic cardiopulmonary bypass managed with indexed flow, cerebral oximetry, calculated indexed oxygen delivery (DO2i), and vasopressor-sparing pressure management.
Settings and Design:: Single-center retrospective descriptive cohort study at a cardiac surgery center.
Material and Methods:: Consecutive adults undergoing elective or urgent cardiac surgery with normothermic cardiopulmonary bypass from June 2023 to December 2025 were included if complete anesthesia–perfusion, regional cerebral oxygen saturation (rSO2), circuit-derived venous oxygen saturation (SvO2), DO2i, and early outcome data were available. Circulatory arrest was excluded. Indexed pump flow was 2.2–2.4 L/min/m². Mean arterial pressure was interpreted with indexed flow, rSO2, SvO2, DO2i, hemoglobin, acid–base status, venous return, and surgical context. Baseline rSO2 was recorded before ventilation on room air; maximal relative decrease during bypass was recorded.
Statistical Analysis Used:: Descriptive statistics and Wilson 95% confidence intervals were used. No comparative testing or causal modeling was performed.
Results:: Two hundred patients were analyzed. Operating-room extubation was achieved in 172 patients (86.0%). Stroke occurred in six (3.0%), acute kidney injury in two (1.0%), and venoarterial extracorporeal membrane oxygenation was required in six (3.0%). Baseline right and left rSO2 were 57.5 ± 11.2% and 58.5 ± 11.3%; maximal relative rSO2 decrease was 28.5 ± 3.4%; circuit-derived SvO2 was 67.4 ± 5.9%; and calculated DO2i was 611 ± 74 mL/min/m².
Conclusions:: This flow-oriented, cerebral oximetry-guided, oxygen-delivery-aware strategy was accompanied by favorable early recovery. Because the study was retrospective and noncomparative, the findings are hypothesis-generating.
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BibTeX
@article{chibisov2026cerebral,
title = {{Cerebral Oxygenation-Guided Indexed-Flow Normothermic Cardiopulmonary Bypass with Vasopressor-Sparing Pressure Management: A Retrospective Descriptive Cohort Study}},
author = {Nikita Chibisov and Andrey Kornienko and Anatoly Malyshev and Evgeny Rodionov and Igor Glushenko and Mikhail Shtrymov},
journal = {Annals of Cardiac Anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/aca.aca_170_26},
url = {https://doi.org/10.4103/aca.aca_170_26},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Cerebral Oxygenation-Guided Indexed-Flow Normothermic Cardiopulmonary Bypass with Vasopressor-Sparing Pressure Management: A Retrospective Descriptive Cohort Study
AU - Nikita Chibisov
AU - Andrey Kornienko
AU - Anatoly Malyshev
AU - Evgeny Rodionov
AU - Igor Glushenko
AU - Mikhail Shtrymov
PY - 2026
DA - 2026/10/12
JO - Annals of Cardiac Anaesthesia
DO - 10.4103/aca.aca_170_26
UR - https://doi.org/10.4103/aca.aca_170_26
AB - Context:: Mean arterial pressure targets during cardiopulmonary bypass remain debated; vasopressor-driven pressure augmentation may not improve oxygen delivery. Aims:: The aim of the paper is to describe clinical outcomes and physiologic markers during normothermic cardiopulmonary bypass managed with indexed flow, cerebral oximetry, calculated indexed oxygen delivery (DO2i), and vasopressor-sparing pressure management. Settings and Design:: Single-center retrospective descriptive cohort study at a cardiac surgery center. Material and Methods:: Consecutive adults undergoing elective or urgent cardiac surgery with normothermic cardiopulmonary bypass from June 2023 to December 2025 were included if complete anesthesia–perfusion, regional cerebral oxygen saturation (rSO2), circuit-derived venous oxygen saturation (SvO2), DO2i, and early outcome data were available. Circulatory arrest was excluded. Indexed pump flow was 2.2–2.4 L/min/m². Mean arterial pressure was interpreted with indexed flow, rSO2, SvO2, DO2i, hemoglobin, acid–base status, venous return, and surgical context. Baseline rSO2 was recorded before ventilation on room air; maximal relative decrease during bypass was recorded. Statistical Analysis Used:: Descriptive statistics and Wilson 95% confidence intervals were used. No comparative testing or causal modeling was performed. Results:: Two hundred patients were analyzed. Operating-room extubation was achieved in 172 patients (86.0%). Stroke occurred in six (3.0%), acute kidney injury in two (1.0%), and venoarterial extracorporeal membrane oxygenation was required in six (3.0%). Baseline right and left rSO2 were 57.5 ± 11.2% and 58.5 ± 11.3%; maximal relative rSO2 decrease was 28.5 ± 3.4%; circuit-derived SvO2 was 67.4 ± 5.9%; and calculated DO2i was 611 ± 74 mL/min/m². Conclusions:: This flow-oriented, cerebral oximetry-guided, oxygen-delivery-aware strategy was accompanied by favorable early recovery. Because the study was retrospective and noncomparative, the findings are hypothesis-generating.
SN - 0971-9784
SN - 0974-5181
ER -