Optimal Cerebral Perfusion Pressure and Brain Tissue Oxygen in Aneurysmal Subarachnoid Hemorrhage

Abstract

We found a nonlinear relationship between PbtO₂ and deviation of patients' CPP from CPPopt in aneurysmal subarachnoid hemorrhage patients in the pre-DCI period. CPP values below calculated CPPopt were associated with lower PbtO₂. Nevertheless, the nature of PbtO₂ measurements is complex, and the variability is high. Combined multimodality monitoring with CPP/CPPopt and PbtO₂ should be recommended to redefine individual pressure targets (CPP/CPPopt) and retain the option to detect local perfusion deficits during DCI (PbtO₂), which cannot be fulfilled by both measurements interchangeably.