In management of severe traumatic brain injury, the Lund concept of ICP management differs from the Rosner concept primarily in its approach to which physiological target?

• A Target cerebral perfusion pressure is kept high (>70 mmHg) in the Lund concept
• B The Lund concept uses vasopressors to increase MAP and improve CPP
• C The Rosner concept uses aggressive hyperventilation to reduce ICP
• D The Lund concept targets low to normal CPP (~50–70 mmHg) with reduction of intravascular volume stress on the cerebral vasculature ✓

Explanation

The Lund concept focuses on reducing cerebral blood volume and ICP by reducing cerebral capillary hydrostatic pressure through vasodilators (e.g., metoprolol, clonidine) and albumin infusion to maintain colloid osmotic pressure, targeting CPP of 50–70 mmHg. In contrast, the Rosner (CPP-targeted) approach maintains CPP above 70 mmHg using vasopressors and fluid loading. The Lund concept is used primarily in Scandinavia and aims to reduce cerebrovascular stress rather than augment perfusion pressure.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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