{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:17:06Z","timestamp":1792034226318,"version":"4.4.0"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intra\u2010operative hypotension is common during cardiopulmonary bypass and may contribute to tissue hypoxia. Tissue hypoxia has been linked to the development of postoperative kidney and brain injury. Vasopressors are used to treat hypotension during and after cardiopulmonary bypass. However, the effects of these drugs on renal and cerebral tissue oxygenation and perfusion are unknown. We tested the effects of four vasopressors on renal and cerebral tissue perfusion and oxygenation in a clinically\u2010relevant ovine model of cardiopulmonary bypass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We studied 16 sheep before and after induction of anaesthesia and during 2.5\u2009h of cardiopulmonary bypass. After commencing cardiopulmonary bypass at a target non\u2010pulsatile flow of 2.4\u2009l.min\n                      <jats:sup>\u20101<\/jats:sup>\n                      .m\n                      <jats:sup>\u20102<\/jats:sup>\n                      , we observed a baseline period with a target mean arterial pressure of 50\u201360\u2009mmHg, after which we targeted a mean arterial pressure of 75\u201385\u2009mmHg using a continuous infusion of metaraminol (n\u2009=\u20098); noradrenaline (n\u2009=\u20098); phenylephrine (n\u2009=\u20098); or vasopressin (n\u2009=\u20097). Sheep were allocated randomly to receive two of the four vasopressors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the pre\u2010induction state, cardiopulmonary bypass significantly decreased renal medullary tissue perfusion (median (IQR [range]) decrease 55 (4\u201382 [1\u201399])%; p\u2009=\u20090.01) and medullary oxygen tension (mean (SD) difference 3.1 (2.5) kPa; p\u2009&lt;\u20090.001). Cardiopulmonary bypass did not significantly alter cerebral tissue perfusion or oxygenation compared with the pre\u2010induction state. Infusing noradrenaline significantly decreased medullary oxygen tension (mean (SD) difference 2.7 (1.6) kPa; p\u2009=\u20090.003). This decrease\u00a0in medullary oxygen tension was significant compared with vasopressin (mean difference \u20103.4\u00a0kPa, 95%CI \u20105.7 to \u20101.0; p\u2009=\u20090.008). No vasopressor infusion significantly altered renal medullary perfusion, cerebral tissue perfusion or oxygenation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Intra\u2010operative noradrenaline during ovine cardiopulmonary bypass worsens renal medullary tissue oxygenation relative to vasopressin. These findings suggest that the choice of vasopressors may affect renal oxygenation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70049","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T09:09:56Z","timestamp":1762765796000},"page":"383-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Effects of noradrenaline, vasopressin, phenylephrine or metaraminol on kidney and brain microcirculation in ovine cardiopulmonary bypass: a randomised trial"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2669-7836","authenticated-orcid":false,"given":"Alemayehu H.","family":"Jufar","sequence":"first","affiliation":[{"name":"Pre\u2010clinical Critical Care Unit Florey Institute of Neuroscience and Mental Health  Parkville VIC 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 Parkville VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-6882","authenticated-orcid":false,"given":"Peter R.","family":"McCall","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne VIC Australia"},{"name":"Department of Anaesthesia Austin Health  Heidelberg VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9101-7649","authenticated-orcid":false,"given":"Abraham","family":"Hulst","sequence":"additional","affiliation":[{"name":"Pre\u2010clinical Critical Care Unit Florey Institute of Neuroscience and Mental Health  Parkville VIC Australia"},{"name":"Department of Anaesthesiology Amsterdam UMC, The University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally G.","family":"Hood","sequence":"additional","affiliation":[{"name":"Pre\u2010clinical Critical Care Unit Florey Institute of Neuroscience and Mental Health  Parkville VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4058-8905","authenticated-orcid":false,"given":"Anton","family":"Trask\u2010Marino","sequence":"additional","affiliation":[{"name":"Pre\u2010clinical Critical Care Unit Florey Institute of Neuroscience and Mental Health  Parkville VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1650-8939","authenticated-orcid":false,"given":"Rinaldo","family":"Bellomo","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Melbourne Medical School The University of Melbourne  Melbourne VIC Australia"},{"name":"Department of Intensive Care Austin Health  Heidelberg VIC Australia"},{"name":"Australian and New Zealand Intensive Care Research Centre 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