Question 24

Define cerebral perfusion pressure (CPP).  List the advantages  and limitations of using

CPP as a therapeutic target in the management of traumatic brain injury

[Click here to toggle visibility of the answers]


Definition : CPP = MAP-ICP Advantages: Easily monitored

Can be monitored continuously

Nursing staff familiar

BTF guidelines endorse use of CPP at 60

Limitations: Used as a surrogate for CBF

CVR is variable and therefore changes in CBF not detected by CPP

Does not allow for differential autoregulation in the normal and injured brain. Therapy to maintain CPP can result in lung injury

No Class I data to support use

Poor correlation between CPP and indices of brain oxygenation


This question closely resembles Question 1 from the second paper of 2009.