Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 19 2 2024 04 30 96 101 Afzal Shamsi 1-Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. 2-Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran. Senan Salim Alaroofa Department of Anesthesia, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Dehghani Firoozabadi Department of Anesthesiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Dena A. AlKazzaz Division of Anesthesia, Department of Surgery, College of Medicine, University of Mosul, Mosul, Iraq. Behrang Nooralishahi 2-Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran. 5-Department of Anesthesiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammadjavad Mehrabanian Department of Anesthesiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran 2024 01 17 2024 01 28 Background: Maintaining an optimal mean arterial pressure (MAP) is vital for cerebral blood flow and the overall health of patients undergoing coronary artery bypass graft (CABG) surgery. This study investigated the impact of low MAP on cerebral blood flow and in-hospital clinical outcomes in CABG candidates at our hospital. Methods: We compared a convenience sample of 55 patients with a low MAP (55 mmHg) and 54 patients with a high MAP (75 mmHg) who underwent CABG at Tehran Heart Center in 2023. We recorded the patients' demographic and clinical characteristics by measuring cerebral oximeter readings and lactate levels pre- and post-operation. We then compared the baseline and postoperative characteristics between the 2 groups and determined the impact of MAP on their postoperative changes. Results: The groups were statistically similar at baseline, except for a lower pH in the low MAP group (55 mmHg) (P=0.016). The preoperative and postoperative measurements (including lactate levels and cerebral oximeter readings) did not differ between the groups. However, heart rate was significantly higher in the high MAP group (75 mmHg) (P=0.034). The adjusted effect of baseline MAP on selected postoperative characteristics showed that it could significantly but inversely influence heart rate (β coefficient=-5.952; P=0.017) and had a borderline effect on troponin (β coefficient=1.734; P=0.051) and HCO3 (β coefficient=0.785; P=0.062). Conclusion: MAP did not significantly influence clinical outcomes in our study. Nonetheless, maintaining an optimal MAP is essential for preventing cerebral injury and ensuring adequate cerebral oxygenation in CABG patients. https://rhythm.tums.ac.ir/index.php/jthc/article/view/2006