Low Cerebral Perfusion Pressure Increases Delirium Risk After Cardiac Surgery

Postoperative delirium remains a prevalent and serious complication following cardiac surgery, frequently resulting in prolonged intensive care unit stays and higher rates of in-hospital mortality [1, 2]. Despite the use of various pharmacological interventions to mitigate this risk, the incidence of neurocognitive impairment remains high [3, 4]. Current clinical guidelines underscore the importance of identifying modifiable intraoperative factors, yet the specific role of blood pressure management in preventing delirium is still debated [5, 6]. While some evidence suggests that intraoperative hypotension may prolong recovery, meta-analyses have often failed to establish a definitive correlation between mean arterial pressure alone and postoperative delirium [5, 7]. A recent retrospective cohort study investigates whether the relationship between arterial and venous pressures, which dictates cerebral perfusion pressure (the net pressure gradient driving blood flow to the brain), offers a more accurate predictor of delirium risk.