Recommendation Table 40.

Recommendations for control of mean arterial blood pressure during cardiopulmonary bypass

Recommendations	Class a	Level b	Ref c
It is recommended that the MAP be maintained between 50 and 80 mmHg with vasoconstrictors and vasodilators if required, having ensured that the depth of anaesthesia and pump flow rate are sufficient.	I	A	381,511
The use of vasopressors to increase the MAP to values above 80 mmHg during CPB is not recommended.	III	B	381,510,517
Targeting the MAP during CPB within the limits of individualized cerebral autoregulation data, measured under normocapnic conditions before CPB, should be considered whenever the technical and human skills are available.	IIa	A	222,519,520
It is recommended that vasoplegic syndrome during CPB be treated with α1-adrenergic agonists and/or vasopressin.	I	C	521,523
In refractory vasoplegic syndrome, alternative drugs (methylene blue or terlipressin) should be considered, alone or in combination.	IIa	B	522,523
Hydroxocobalamin or angiotensin II may be considered to treat vasoplegic syndrome during CPB.	IIb	C	524, 525, 526, 527

CPB: cardiopulmonary bypass; MAP: mean arterial pressure.

^aClass of recommendation.

^bLevel of evidence.

^cReferences.