Zagriychuk I. The effectiveness of cerebral perfusion pressure monitoring in patients with severe traumatic brain injury

The effectiveness of cerebral perfusion pressure (CPP) monitoring was studied in 80 patients aged from 18 to 60 years with severe traumatic brain injury (TBI), been treated in neurosurgical units of Ternopil University hospital and in Kiev clinical hospital of emergency medicine in the period from 2010 to 2012. It was established that ischemia of the brain dominated in patients with severe TBI ant defined results of their treatment. Maintenance of stable CPP level - is the main purpose of treatment of intracranial posttraumatic hypertension. Minimal CPP level - 70 mm Hg and higher, optimal - more often is higher and defined individually and can reach 100 mm Hg, but usually makes 85 mm Hg. Artificial rising of CPP level does not worsen intracranial hypertension flow. The method of pharmaceutical CPP maintenance was designed and proposed for clinical practice in units of neurosurgery and intensive care. The technology of stable CPP maintenance includes providing condition of normal volume or some hypovolume due to continuous infusion of dopaminum and noradrenalinum. Important point of stable CPP maintenance is periodic infusions of Mannitolum. Simultaneous monitoring of intracranial pressure, CPP and venous blood saturation, flowing off from the brain, provides support of optimal CPP and depression of mortality of patients with TBI for 36.8%; it is recommended as obligatory monitoring in patients with severe TBI.