Computer control versus manual control of systemic hypertension during cardiac surgery.
BACKGROUND
We recently demonstrated the feasibility of computer controlled infusion of vasoactive drugs for the control of systemic hypertension during cardiac surgery. The objective of the current study was to investigate the effects of computer controlled blood pressures on hemodynamic stability when compared to conventional manual control.


METHODS
Systemic artery blood pressures were managed either by computer (80 patients) or by a well-trained anesthesiologist (80 patients). The vasodilator drugs sodium nitroprusside and nitroglycerin were used. Hemodynamic stability was determined from the standard deviation of the mean arterial pressure samples and from the percentages of time that arterial pressure was hypertensive or hypotensive.


RESULTS
The average standard deviation of the mean arterial pressure samples was smaller for the computer controlled than for the manually controlled group: 7.5+/-2.2 (mean+/-SD) versus 8.9+/-2.3 mmHg (P<0.0001). The systemic artery pressure was less hypertensive and less hypotensive in the computer controlled than in the manually controlled group: 9.4+/-5.7 versus 13.1+/-6.0% (P<0.0001) and 8.0+/-5.9 versus 11.8+/-7.4% (P<0.0001), respectively.


CONCLUSIONS
We conclude that, compared with manual control, computer control of systemic hypertension significantly improved hemodynamic stability during cardiac surgery.
Hoeksel
S A
SA
Department of Anesthesiology, Cardiovascular Research Institute, Maastricht University, Maastricht, The Netherlands.
Blom
J A
JA
Jansen
J R
JR
Maessen
J G
JG
Schreuder
J J
JJ
D000328:Adult; D002302:Cardiac Output / Q000187:drug effects; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D003201:Computers; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007262:Infusions, Intravenous; D008297:Male; D016343:Monitoring, Intraoperative; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use; D009599:Nitroprusside / Q000008:administration & dosage / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use*
D014665:Vasodilator Agents; D009599:Nitroprusside; D005996:Nitroglycerin