🧠 Cerebral Perfusion Pressure (CPP) & ICP Targets
Cerebral perfusion pressure (CPP = MAP − ICP) and intracranial-pressure targets in severe TBI and neurocritical care.
Maintaining CPP > 70 with vasopressors raises ARDS and volume-overload risk — CPP is an optimization target, not 'higher is better' (original synthesis · not guideline verbatim).
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When to use
Use to compute CPP from blood pressure and ICP and to check it against Brain Trauma Foundation targets.
How it works
MAP = DBP + (SBP − DBP)/3; CPP = MAP − ICP; severe-TBI target CPP 60–70 mmHg; ICP > 22 mmHg triggers ICP-lowering therapy.
Key points
- Maintaining CPP > 70 with vasopressors raises ARDS and volume-overload risk — CPP is an optimization target, not 'higher is better' (original synthesis · not guideline verbatim).
- Zero the arterial transducer at the tragus (≈ foramen of Monro) so MAP/CPP reflect cerebral, not cardiac, level.
- When autoregulation is impaired, cerebral blood flow follows CPP passively, making both hypo- and hypertension hazardous.
References
- Carney N, et al. Brain Trauma Foundation severe-TBI guidelines, 4th ed. Neurosurgery 2017.
- Hawryluk GWJ, et al. ICP/CPP management consensus (SIBICC). Intensive Care Med 2019.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Systolic BP SBP | 130 mmHg |
|---|---|
| Diastolic BP DBP | 70 mmHg |
| Intracranial pressure ICP | 18 mmHg |
→CPP72 mmHg
- Calculation：MAP = 90 mmHg (DBP + (SBP − DBP)/3); CPP = MAP − ICP = 90 − 18 = 72 mmHg
- CPP evaluation：Normal-high (> 70; if maintained by vasopressors, watch for ARDS)
- ICP evaluation：ICP 18 (≤ 20 broadly acceptable)
Frequently asked questions
- What is Cerebral Perfusion Pressure (CPP) & ICP Targets?
- Cerebral perfusion pressure (CPP = MAP − ICP) and intracranial-pressure targets in severe TBI and neurocritical care.
- How is Cerebral Perfusion Pressure (CPP) & ICP Targets calculated? What is the core formula?
- MAP = DBP + (SBP − DBP)/3; CPP = MAP − ICP; severe-TBI target CPP 60–70 mmHg; ICP > 22 mmHg triggers ICP-lowering therapy.
- When is Cerebral Perfusion Pressure (CPP) & ICP Targets used?
- Use to compute CPP from blood pressure and ICP and to check it against Brain Trauma Foundation targets.
- What are the key clinical points for Cerebral Perfusion Pressure (CPP) & ICP Targets?
- Maintaining CPP > 70 with vasopressors raises ARDS and volume-overload risk — CPP is an optimization target, not 'higher is better' (original synthesis · not guideline verbatim). Zero the arterial transducer at the tragus (≈ foramen of Monro) so MAP/CPP reflect cerebral, not cardiac, level. When autoregulation is impaired, cerebral blood flow follows CPP passively, making both hypo- and hypertension hazardous.
- What are the limits and cautions when using Cerebral Perfusion Pressure (CPP) & ICP Targets?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Cerebral Perfusion Pressure (CPP) & ICP Targets calculated in practice? Can you show a worked example?
- Inputs: Systolic BP SBP 130 mmHg, Diastolic BP DBP 70 mmHg, Intracranial pressure ICP 18 mmHg → Result: CPP 72 mmHg（Calculation: MAP = 90 mmHg (DBP + (SBP − DBP)/3); CPP = MAP − ICP = 90 − 18 = 72 mmHg, CPP evaluation: Normal-high (> 70; if maintained by vasopressors, watch for ARDS), ICP evaluation: ICP 18 (≤ 20 broadly acceptable)）