• Vytautas Petkus, Aidanas Preiksaitis, Solventa Krakauskaite, Erika Zubaviciute, Saulius Rocka, Daiva Rastenyte, Saulius Vosylius, and Arminas Ragauskas.
• Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.
• J Crit Care. 2017 Oct 1; 41: 49-55.

PurposeThe maintenance of patient-specific optimal cerebral perfusion pressure (CPPopt) is crucial for patients with traumatic brain injury (TBI). The goal of the study was to explore the influence of CPP declination from CPPopt value on the TBI patients' outcome.MethodsThe CPP and cerebrovascular autoregulation (CA) monitoring of 52 TBI patients was performed. Patient-specific CPPopt has been identified and the associations between the patients' outcome and complex influence of time of CPP declination from CPPopt value, age, and the duration of CA impairment episodes has been analyzed.ResultsThe multiple correlation coefficient between the Glasgow outcome scale (GOS), duration of CA impairment events and percentage time, when 0<ΔCPPopt<10mmHg was r=-0.643 (P<0.001). The multiple correlation coefficients between GOS, age, and percentage time of ΔCPPopt when 0<ΔCPPopt<10mmHg was r=-0.587 (P<0.001).ConclusionThe CPPopt-targeted patient-specific management might be useful for stabilizing CA in TBI patients as well as for improving their outcome. Better outcomes were obtained by maintaining CPP in light hyperperfusion condition (up to 10mmHg above CPPopt) when CPPopt is in the range of 60-80mmHg, and keeping CPP within the range of CPPopt +/-5mmHg when CPPopt is above 80mmHg.Copyright © 2017 Elsevier Inc. All rights reserved.

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