Coda Change

Optimal Cerebral Perfusion Pressure

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Jul 19, 2023
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INSIGHT

CPP And MAP Interact Dynamically

  • CPP and MAP are not independent; changing MAP can alter ICP through vascular responses.
  • Increasing MAP can lower ICP by improving cerebral autoregulation rather than always raising ICP.
ANECDOTE

Successful MAP Increase Example

  • In a case the team increased noradrenaline from 17 to 23 and MAP rose from 80 to 87.
  • ICP fell from 21 to 18 over 30 minutes, improving bedside comfort.
ADVICE

How To Run A MAP Challenge Safely

  • Perform a MAP challenge under direct clinician supervision with no other interventions.
  • Increase vasopressors, observe ICP response, and adjust therapy based on the result.
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