intracranial pressure ICP and cerebral perfusion pressure goals and treatment in TBI

• related: traumatic brain injury overview
• tags: #permanent

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The goal in traumatic brain injury is to keep cerebral perfusion pressure, or CPP, above 60 mmHg. CPP is the pressure necessary to maintain cerebral blood flow. It's $MAP - ICP$.

The two ways to improve CPP is to either improve MAP or decrease ICP. Blood pressure should be monitored:

• Keep SBP > 110 for patients <50 and >70
• Keep SBP > 100 for patients 50 - 60
• Permissive hypertension with SBP <180
• Use pressors with caution as they may increase ICP while increase the MAP. This happens more often in patients who have lost their autoregulation. In a normal person, increase in SBP only transiently increases ICP

The goal for ICP is less than 22. Treatment is often initiated for patients with ICP greater than 22. treatment for elevated ICP includes hypertonic saline and mannitol is discussed separately.

Links to this note

• traumatic brain injury overview
  • intracranial pressure ICP and cerebral perfusion pressure goals and treatment in TBI
• treatment for elevated ICP includes hypertonic saline and mannitol
  • related: intracranial pressure ICP and cerebral perfusion pressure goals and treatment in TBI, traumatic brain injury overview
  • Give hypertonic saline for patients with elevated ICP (intracranial pressure ICP and cerebral perfusion pressure goals and treatment in TBI)