SynthesisCanadian journal of anaesthesia = Journal canadien d'anesthesie2022
Morbidity and mortality in patients managed with high compared with low blood pressure targets during on-pump cardiac surgery: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.British journal of anaesthesia · 2025Guideline
- Higher blood pressure versus normotension targets to prevent acute kidney injury: a systematic review and meta-regression of randomized controlled trials.Critical care (London, England) · 2022Pooled it
- Trial
- Impact of cardiopulmonary bypass flow on the lower limit of cerebral autoregulation during cardiac surgery: a randomized cross-over pilot study.Journal of clinical monitoring and computing · 2025Trial
- Mean Arterial Pressure During the First 24 Hours After Cardiac Surgery and Acute Kidney Injury: An Observational Cohort Study.Journal of cardiothoracic and vascular anesthesia · 2026Observational
- Cerebral protection strategies in aortic arch surgery: a review of techniques and outcomes.Annals of cardiothoracic surgery · 2026Article
- Preoperative Transcranial Doppler Findings and Postoperative Delirium After Cardiac Surgery in Elderly Patients: A Prospective Observational Study.Life (Basel, Switzerland) · 2026Article
- Article
- Association between postoperative nocturnal blood pressure rising and mortality in patients receiving cardiac surgery: a retrospective cohort study.BMC cardiovascular disorders · 2026Article
- Effect of intraoperative hypotension depth and duration on acute kidney injury after Type A acute aortic dissection repair: An observational cohort study based on early risk stratification models.Journal of anesthesia and translational medicine · 2025Article
- Blood pressure management during cardiac surgery: a survey of Canadian cardiac anesthesiologists, perfusionists, and cardiac surgeons.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
- Hemodynamic control during cardiopulmonary bypass and the incidence of postoperative delirium- a post hoc analysis.BMC anesthesiology · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Prebypass Critical Closing Pressure Predicts Acute Kidney Injury After Cardiopulmonary Bypass.Journal of cardiothoracic and vascular anesthesia · 2025Article
- Baseline and 7-Year longitudinal trajectories of systolic blood pressure and all-cause mortality in the elderly: A large prospective cohort study in China, 2017-2023.AIMS public health · 2025Article
- Target flow deviations on the cardiopulmonary bypass cause postoperative delirium in cardiothoracic surgery-a retrospective study evaluating temporal fluctuations of perfusion data.Interdisciplinary cardiovascular and thoracic surgery · 2024Article
- Captopril to Lisinopril Conversion in Pediatric Cardiothoracic Surgery Patients Less Than 7 Years of Age (RISE-7).Pediatric cardiology · 2024Article
- A Rat Model of Clinically Relevant Extracorporeal Circulation Develops Early Organ Dysfunctions.International journal of molecular sciences · 2023Article
- The Conundrum of Systemic Arterial Pressure Management on Cardiopulmonary Bypass.Journal of clinical medicine · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMany believe that blood pressure management during cardiac surgery is associated with postoperative outcomes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the impact of high compared with low intraoperative blood pressure targets on postoperative morbidity and mortality in adults undergoing cardiac surgery on cardiopulmonary bypass (CPB). Our primary objective was to inform the design of a future large RCT. SOURCE: We searched MEDLINE, EMBASE, Web of Science, CINAHL, and CENTRAL for RCTs comparing high with low intraoperative blood pressure targets in adult patients undergoing any cardiac surgical procedure on CPB. We screened reference lists, grey literature, and conference proceedings. PRINCIPAL
findingsWe included eight RCTs (N =1,116 participants); all examined the effect of blood pressure management only during the CPB. Trial definitions of high compared with low blood pressure varied and, in some, there was a discrepancy between the target and achieved mean arterial pressure. We observed no difference in delirium, cognitive decline, stroke, acute kidney injury, or mortality between high and low blood pressure targets (very-low to low quality evidence). Higher blood pressure targets may have increased the risk of requiring a blood transfusion (three trials; n = 456 participants; relative risk, 1.4; 95% confidence interval, 1.1 to 1.9; P = 0.01; moderate quality evidence) but this finding was based on a small number of trials.
conclusionIndividual trial definitions of high and low blood pressure targets varied, limiting inferences. The effect of high (compared with low) blood pressure targets on other morbidity and mortality after cardiac surgery remains unclear because of limitations with the body of existing evidence. Research to determine the optimal management of blood pressure during cardiac surgery is required. STUDY REGISTRATION: PROSPERO (CRD42020177376); registered: 5 July 2020.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.