Sharjeel Abbas, Waseem Riaz, Irfan Azmatullah Khwaja, Madiha Iqbal, Zafar Tufail, Abdul Waheed.
Mean arterial pressure and pulse pressure, influence on postoperative renal and neurological outcomes in elderly patients undergoing coronary revascularization.
Pak Heart J Jan ;48(4):194-9.

Objectives: To observe the impact of both MAP and PP for the postoperative renal and neurological outcomes in patients undergoing CABG. Methodology: This prospective double blinded observational study of patients undergoing 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 Carotid Doppler study was performed. Postoperatively RIFLE criteria was used for Acute Renal Injury. Patients with neurological deficit and seizures underwent CT and EEG. Data was analyzed by using SPSS 20. P 0.05 was considered as significant. Results: Total number of patients included were 115. Co morbid conditions found in 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 pressure between 31-40 mmHg & mean arterial pressure between 71-90 mmHg. The only association of ARI was found with hypertension (p=0.050). Stroke, RIND, TIA,coma and seizures had no association with pulse pressure < 30mmHg and Mean arterial pressure of < 70mmHg. Conclusion: For post CABG patients MAP and PP are good markers for the neurological deficit but not for renal disease.

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