Abstract

Traumatic brain injury (TBI) is a major cause of death and disability. In the 2000 guidelines, one of the suggestions for TBI treatment was to maintain cerebral perfusion pressure (CPP) < 70 mmHg. But in the 2003 guidelines, the suggestion was changed to < 60 mrnHg. There have been some discrepancies of opinions about this recommendation in recent publications. In this study, we retrospectively reviewed 305 severe TBI (STBI) patients with Glasgow Coma Scales (GCS) <8 between January 1, 2002 and March 31, 2003. The study group was stratified according to use or nonuse of intracranial pressure (ICP) monitoring, ICP levels, ages, and GCS levels in order to test the correlation between CCP and the prognosis. The patients <50-year-old, with higher GCS level, with ICP monitoring, and with ICP levels <20 mrnHg had lower mortality rates and better prognosis (GOS) (p<0.05 or 0.001). The patients in the GCS 3-5 subgroup had a significantly lower mortality and better prognosis if the CPP value was maintained higher than 70 mmHg (p < 0.05) The optimal CPP maintained ≤ 60 mmHg did not fit in all STBI patients. Our study concludes that it is critical to maintain CPP substantially higher in lower GCS level patients.
Original languageEnglish
Title of host publicationActa Neurochirurgica, Supplementum
Pages131-136
Number of pages6
Edition101
DOIs
Publication statusPublished - 2008

Publication series

NameActa Neurochirurgica, Supplementum
Number101
ISSN (Print)00651419

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Keywords

  • cerebral perfusion pressure (CPP)
  • Glasgow coma scale (GCS)
  • Glasgow outcome scale (GOS)
  • intracranial pressure (ICP)
  • Traumatic brain injury (TBI)

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Lin, J-W., Tsai, J-T., Lin, C-M., Lee, L-M., Hung, K-S., Huang, S. J., Hsiao, S. H., Chung, W. Y., Tsai, M. D., Hsia, C. C., Hung, C. C., & Chiu, W-T. (2008). Evaluation of optimal cerebral perfusion pressure in severe traumatic brain injury. In Acta Neurochirurgica, Supplementum (101 ed., pp. 131-136). (Acta Neurochirurgica, Supplementum; No. 101). https://doi.org/10.1007/978-3-211-78205-7-22