Hypotension and Perioperative Strokes in Cardiac Surgery: How Big Data Can Help Answer Big Questions.

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Abstract

Stroke is one of the most feared complications after cardiac surgery and an important contributor to long-term disability and healthcare spending. Intraoperative hypotension is a known risk factor for stroke; however, there are currently no guidelines in the context of cardiac surgery to recommend what intraoperative blood pressure threshold should be targeted to mitigate this complication. Investigations to quantify this relationship have traditionally been limited by the lack of high-resolution hemodynamic data, as well as failure to differentiate between the pre- and post-cardiopulmonary bypass (CPB) periods. Additionally, factors unique to cardiac surgery, such as the physiologic effect of cardiopulmonary bypass, need to be considered. Big data, or large amounts of routinely collected data, is a powerful tool that could be leveraged to address these unanswered questions. This new tool can expand the horizons of our knowledge regarding personalized perioperative monitoring and hemodynamic management.

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