In a ventilated patient with severe traumatic brain injury, the goal of therapy is to maintain cerebral perfusion pressure within a defined range. Cerebral perfusion pressure is calculated as:

• A Mean arterial pressure divided by intracranial pressure
• B Systolic blood pressure minus central venous pressure
• C Mean arterial pressure minus intracranial pressure ✓
• D Mean arterial pressure minus pulmonary capillary wedge pressure

Explanation

Cerebral perfusion pressure equals mean arterial pressure minus intracranial pressure, reflecting the gradient driving blood across the cerebral circulation. Current Brain Trauma Foundation guidance targets a CPP of approximately 60 to 70 mmHg in adults with severe head injury. Below this range cerebral ischaemia occurs, while pushing CPP higher than about 70 mmHg using aggressive fluids and vasopressors increases the risk of adult respiratory distress syndrome without improving outcome.

Reference: Greenfield's Surgery: Scientific Principles and Practice, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.