McNett Molly, Livesay Sarah, Yeager Susan, Moran Cristina, Supan Erin, Ortega Stefany, Olson DaiWai M
Sarah Livesay, DNP ACNP FNCS, is Associate Professor, Rush University, Chicago, IL. Susan Yeager, MS ACNP FNCS, is Nurse Practitioner Lead, Wexner Medical Center, The Ohio State University, Columbus, OH. Cristina Moran, MSN RN CCRN, is Clinical Nurse, The MetroHealth System, Cleveland, OH. Erin Supan, MSN RN, is Clinical Nurse Specialist, Neurosciences, University Hospitals Cleveland Medical Center, Cleveland, OH. Stefany Ortega, MSc RN, is Assistant Professor, Universidad del Norte, Barranquilla, Colombia. DaiWai M. Olson, PhD RN CCRN FNCS, is Professor of Neurosurgery and Neurotherapeutics, University of Texas Southwestern, Dallas, TX.
J Neurosci Nurs. 2018 Dec;50(6):322-326. doi: 10.1097/JNN.0000000000000398.
Head-of-bed (HOB) elevation is the standard of care for patients with intracranial pressure monitoring at risk for intracranial hypertension. Measurement of cerebral perfusion pressure (CPP) based on HOB elevation and arterial transducer position has not been adequately studied.
This is a planned secondary analysis of prospectively collected data in which paired, serial arterial blood pressure (ABP), intracranial pressure, and CPP measures were obtained once per day for 3 days, with measures leveled at the tragus (Tg) and the phlebostatic axis (PA). The HOB position was recorded for all paired readings.
From 136 subjects, ABP and CPP values were lower when the transducer was leveled at the Tg, compared with the PA (P < .001); these differences persisted regardless of HOB position.
The difference in CPP when ABP is referenced at the Tg versus PA is not consistently attributed to HOB elevation.
床头抬高是颅内压监测且有颅内高压风险患者的护理标准。基于床头抬高和动脉换能器位置测量脑灌注压（CPP）尚未得到充分研究。
这是一项对前瞻性收集数据的计划二次分析，其中连续3天每天获取一次配对的系列动脉血压（ABP）、颅内压和CPP测量值，测量值以耳屏（Tg）和静脉压轴（PA）为水平参考。记录所有配对读数时的床头位置。
在136名受试者中，与以PA为水平参考相比，当换能器以Tg为水平参考时，ABP和CPP值更低（P <.001）；无论床头位置如何，这些差异均持续存在。
当ABP以Tg为参考与以PA为参考时，CPP的差异并不总是归因于床头抬高。
