The Impact of Blood Pressure below Personalized Lower Cerebral Autoregulation Limit on Outcomes after Cardiac Surgery: A Retrospective Study

Objective: The clinical importance of individualized blood pressure management in optimizing cerebral perfusion during cardiac surgery has been well established. However, consensus on blood pressure goals is lacking. The authors studied the associations between cerebral autoregulation metrics, hemodynamic parameters, and postoperative outcomes, and hypothesized that increased time of mean arterial pressure (MAP) below the lower limit of autoregulation (LLA) is associated with major morbidity and mortality (MMOM) incidence. Design: A retrospective, observational study. Setting: A university hospital. Participants: A total of 686 cardiovascular surgeries were included. Intervention: None. Measurement and Main Results: The area under the time-pressure curve (AUC) for MAP < LLA and time below LLA (AUC(ABP48 hours, and postoperative mortality (ie, MMOM). There was no significant association between AUC(ABP 0.05). Relationships were observed between components of MMOM-operative mortality (p < 0.05) and low cardiac output syndrome (p < 0.05)-and AUC(ABP