Neuroanesthesia & neurocritical care
Cerebral perfusion pressure targets after traumatic brain injury: a reappraisal
Authors' conclusion
Our findings corroborate experimental work suggesting that TBI patients are more vulnerable to CPP reductions below as compared to elevations above personalized thresholds.
Study context
- Population
- Adult traumatic brain injury (TBI) patients with invasive ICP monitoring and available 6-month outcomes, admitted 2002 to 2023
- Participants
- 809 patients
- Exposure
- Deviations of cerebral perfusion pressure (CPP) below vs above fixed or personalized targets
- Outcome
- Outcome (prognostic value of CPP targets)
- Follow-up
- 6 months
Methodological detailsgroup-based trajectory modelling
- Group-based trajectory modelling
Main finding
As reported in the abstract
Worse outcome by CPP below CPPopt and LLA
Odds ratio (CI)P value
Hourly dose below CPPopt
1.04(1.02–1.06)
P < 0.001% time below CPPopt
1.09(1.04–1.15)
P = 0.001Hourly dose below LLA
1.11(1.07–1.14)
P < 0.001% time below LLA
1.26(1.18–1.35)
P < 0.001Observational data: associations, not effects.
Further findings
Mortality by Lower Limit Margin trajectory (CPPopt–LLA distance)
P = 0.003
CPP/PRx relationship
- Asymmetric: steeper PRx increases with decreasing and only modest elevations with increasing CPP
Original publication
Cerebral perfusion pressure targets after traumatic brain injury: a reappraisal. Crit Care. Published 21 May 2025. doi:10.
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