This case focuses on monitoring patients with traumatic brain injury (TBI) by asking the question: Does management of cerebral perfusion pressure (CPP) as the primary goal of therapy yield lower mortality and higher Glasgow Outcome Scale (GOS) scores than that achieved with traditional, intracranial pressure (ICP)-based techniques? This study analyzing patients with TBI who underwent monitoring using CPP, rather than the standard ICP-based monitoring, demonstrated lower rates of mortality and improved outcomes compared with other analyses of patients receiving standard ICP-based monitoring. However, because this was not a controlled study, it is not possible to draw firm conclusions. Current guidelines do not recommend one type of monitoring over another but do provide thresholds for blood pressure, ICP, CPP, and advanced cerebral monitoring.
Modified Lund concept versus cerebral perfusion pressure-targeted therapy: a randomized controlled study in patients with secondary brain ischaemia