Question

A patient has a blood pressure of 128/60, a mean arterial pressure of 75 mm Hg, and an intracranial pressure of 22 mm Hg. What is the cerebral perfusion pressure, and how do you think the anesthesia provider will address it?

A) CPP is low—provider should try to raise blood pressure and ICP.
B) CPP is high—provider should try to lower blood pressure and ICP.
C) CPP is low—provider should try to raise blood pressure and lower ICP.
D) CPP is high—provider should try to raise blood pressure and lower ICP.
E) None of the above options are correct.

Answer 1

The cerebral perfusion pressure (CPP) in this scenario is calculated to be 53 mm Hg, which is low. The appropriate action for the anesthesia provider would be to raise blood pressure and lower intracranial pressure (ICP).

Step-by-step explanation:

The cerebral perfusion pressure (CPP) can be calculated using the formula CPP = MAP - ICP, where MAP stands for mean arterial pressure and ICP stands for intracranial pressure. In this case, the CPP would be 75 mm Hg (MAP) - 22 mm Hg (ICP) = 53 mm Hg. This value is low, considering that the normal range of CPP is typically 70-90 mm Hg. A low CPP can result in insufficient blood flow to the brain, leading to hypoxia and potential neuronal damage.

Given this information, the correct answer is C) CPP is low provider should try to raise blood pressure and lower ICP. The anesthesia provider may address this issue by administering medications to elevate blood pressure or by using therapeutic measures to decrease ICP, such as optimizing head positioning, ensuring adequate ventilation to control carbon dioxide levels, or administering hyperosmolar therapy.