Issues related to increased systemic perfusion pressure during cardiopulmonary bypass and its safety

Abstract

We read with great interest the article by Siepe et al. [1] ‘Increased systemic perfusion pressure during cardiopulmonary bypass (CPB) is associated with less early postoperative cognitive dysfunction and delirium’ along with the conference discussion with Dr Pepper. This prospective, randomized, single-center trial sought to find differences in cognitive outcome after elective or urgent coronary artery bypass grafting (CABG) surgery based on the different systemic perfusion pressures during CPB. On surprisingly low number of patients authors were able to prove statistically significant difference with regard to occurrence of postoperative delirium and concluded that elevated perfusion pressure is not associated with increased morbidity and mortality. We have a few remarks regarding the study and the interpretation of the results.