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Re: Re: [OFFLIST] Re: Question regarding fluid resuscitation

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,

Just Google Mean Arterial Pressure, Cerebral Perfusion Pressure, and

Intracranial Pressure and you will get a slew of great stuff to read.

The problem with a " target systolic " is that CPP depends upon MAP, which depends

partly on diastolic pressure. Therefore, while systolic pressure may " appear "

within normal range, the brain may not be getting enough blood for adequate

perfusion. Level of consciousness is one indicator, but in head injured

patients, LOC may not reflect the true situation with CPP.

The problem is that we must estimate ICP, but we can make some assumptions based

upon Glasgow Coma Scores, LOC, and so forth.

CPP should be maintained at 80, ideally.

I hope this helps.

Gene Gandy

Re: Re: [OFFLIST] Re: Question regarding fluid

resuscitation

I was taught that when dealing with hypovolemia and your patients systolic is

falling past 80. Or there is absent radial pulse. Fluid resuscitation with

hetastarch is best to get the bp back because less fluid is needed and you will

have less of a chance of washing out the blood. However once the bp is back to

80 systolic DX the hetastarch and continue with NS and monitor closely. I was

never taught this ICP formula though. Where can I get more info on this?

-

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