White H. and Venkatesh B
This review discusses the issues relating to cerebral blood flow and cerebral perfusion pressure (CPP) in the treatment of patients with traumatic brain injury. Initial studies indicated that increasing CPP may be beneficial and the Brain Trauma Foundation acknowledged this by incorporating a target of 70 mm Hg in the 1996 guidelines. However, the lack of a demonstrable benefit and the increased complication rate associated with this approach led to a reduction in the CPP goal to 60 mm Hg. With the advancement of neuromonitoring techniques, haemodynamic manipulations and their effects on cerebral metabolism may now be monitored furthering the debate on CPP.
Anesthaesthesia and Analgesia 2008; 107: 979-988