• Molly McNett, Sarah Livesay, Susan Yeager, Cristina Moran, Erin Supan, Stefany Ortega, and DaiWai M Olson.
• Sarah Livesay, DNP ACNP FNCS, is Associate Professor, Rush University, Chicago, IL. Susan Yeager, MS ACNP FNCS, is Nurse Practitioner Lead, Wexner Medical Center, The Ohio State University, Columbus, OH. Cristina Moran, MSN RN CCRN, is Clinical Nurse, The MetroHealth System, Cleveland, OH. Erin Supan, MSN RN, is Clinical Nurse Specialist, Neurosciences, University Hospitals Cleveland Medical Center, Cleveland, OH. Stefany Ortega, MSc RN, is Assistant Professor, Universidad del Norte, Barranquilla, Colombia. DaiWai M. Olson, PhD RN CCRN FNCS, is Professor of Neurosurgery and Neurotherapeutics, University of Texas Southwestern, Dallas, TX.
• J Neurosci Nurs. 2018 Dec 1; 50 (6): 322-326.

IntroductionHead-of-bed (HOB) elevation is the standard of care for patients with intracranial pressure monitoring at risk for intracranial hypertension. Measurement of cerebral perfusion pressure (CPP) based on HOB elevation and arterial transducer position has not been adequately studied.MethodsThis is a planned secondary analysis of prospectively collected data in which paired, serial arterial blood pressure (ABP), intracranial pressure, and CPP measures were obtained once per day for 3 days, with measures leveled at the tragus (Tg) and the phlebostatic axis (PA). The HOB position was recorded for all paired readings.ResultsFrom 136 subjects, ABP and CPP values were lower when the transducer was leveled at the Tg, compared with the PA (P < .001); these differences persisted regardless of HOB position.ConclusionThe difference in CPP when ABP is referenced at the Tg versus PA is not consistently attributed to HOB elevation.

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