Maintaining the CPP within the target window (60–70 mmHg) is a central tenet of Brain Trauma Foundation (BTF) critical care management.
Perfusion Sentinel Probe
Input Mean Arterial Pressure (MAP) and Intracranial Pressure (ICP) to generate the net Cerebral Perfusion Pressure (CPP) and establish risk-stratified clinical targets.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Management of severe traumatic brain injury (TBI) with monitored ICP.
Post-operative neurosurgical monitoring (e.g., after large tumor resection or ICH evacuation).
Optimizing neurological recovery by maintaining adequate cerebral blood flow.
Guiding vasopressor and fluid resuscitation targets.
Section 2
Formula & Logic
Calculation Formula
CPP = MAP − ICP
Biological Basis
The brain is encased in a rigid skull. As intracranial pressure (ICP) rises, it opposes the mean arterial pressure (MAP) driving blood into the brain. CPP represents the net pressure gradient driving cerebral blood flow (CBF). If CPP is too low, ischaemia results; if too high, hyperaemia and worsening oedema occur.
Section 3
Pearls/Pitfalls
Targeting the Sweet Spot
Current BTF guidelines recommend a CPP target of 60–70 mmHg. Going below 60 increase the risk of secondary ischaemic injury. Pushing above 70 without indication increases the risk of ARDS (Adult Respiratory Distress Syndrome) due to aggressive fluid/pressor use without improving neurological outcomes.
Section 4
Evidence Appraisal
Primary Reference
Indications for intracranial pressure monitoring in traumatic brain injury
Hawryluk GWJ et al. • Neurosurg Clin N Am. 2016;27(4):445-452
