In traumatic brain injury, cerebral perfusion pressure (CPP) is calculated as MAP minus ICP. According to Brain Trauma Foundation guidelines, what is the recommended CPP target range for management of severe TBI to balance ischemia prevention and vasopressor overuse?
- A 60-70 mmHg ✓
- B 40-50 mmHg
- C 70-90 mmHg
- D 50-60 mmHg
Correct answer: A. 60-70 mmHg
Explanation
The Brain Trauma Foundation (4th edition) guidelines recommend maintaining CPP between 60-70 mmHg in severe TBI. CPP below 50 mmHg is associated with cerebral ischemia. CPP above 70 mmHg using vasopressors is not recommended as it increases pulmonary complications without improving outcomes. The ICP threshold for treatment is >22 mmHg. Normal MAP is maintained at ≥80 mmHg to achieve adequate CPP given typical ICP values. The 60-70 mmHg window represents the optimal balance based on current evidence.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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