Cerebral perfusion pressure (CPP)

Cerebral perfusion pressure (CPP) is the net pressure gradient that drives cerebral blood flow (CBF) and ensures the delivery of oxygen and nutrients to brain tissue [1]. It is calculated mathematically as the difference between Mean Arterial Pressure (MAP) and Intracranial Pressure (ICP) [2]. CPP is a vital clinical parameter in neurocritical care, particularly for managing patients with traumatic brain injury (TBI), stroke, or intracranial hypertension, where maintaining a specific pressure range is crucial to prevent secondary brain injury [3]. While not a molecular receptor or enzyme, it is a primary physiological target; clinical management involves the use of vasopressors to increase MAP or osmotic agents like mannitol to decrease ICP [1,4]. Maintenance of an optimal CPP range, typically between 60 and 70 mmHg, is essential to sustain cerebral autoregulation and prevent either neuronal ischemia at low pressures or cerebral edema at excessively high pressures [1,5]. Sources: [1] StatPearls (Cerebral Perfusion Pressure); [2] PubMed (PMID: 11261358); [3] Brain Trauma Foundation; [4] Journal of Neurosurgery (CPP management guidelines); [5] Wikipedia (Cerebral Perfusion Pressure).

Other names

CPPBrain perfusion pressure

Drugs maintain CPP by either increasing the mean arterial pressure (MAP) via alpha-adrenergic agonism/vasoconstriction or decreasing the intracranial pressure (ICP) through osmotic diuresis, CSF drainage, or metabolic suppression.