Background: Prevention and treatment of haemodynamic instability and increased intracranial
pressure (ICP) in patients with subarachnoid haemorrhage (SAH) is vital. This study
aimed to evaluate the effects of protocolised cerebral perfusion pressure (CPP)-guided
treatment on morbidity and functional outcome in patients admitted to the intensive
care unit (ICU) with SAH. Methods: We performed a retrospective study comparing 37
patients who received standard haemodynamic treatment (control group) with 17 individuals
(CPP-guided group) who were on the CPP-guided treatment aimed at maintaining CPP >
70 mmHg using both optimisations of ICP and mean arterial pressure (MAP). Results:
MAP, cumulative crystalloid doses and fluid balance were similar in both groups. However,
the incidence of delayed cerebral ischaemia was significantly lower in the CPP-guided
group (14% vs. 64%, p < 0.01), and functional outcome as assessed by the Glasgow Outcome
Scale at 30 days after SAH was improved (29.0% vs. 5.5%, p = 0.03). Conclusions: This
preliminary analysis showed that implementing a CPP-guided treatment approach aimed
at maintaining a CPP > 70 mmHg may reduce the occurrence of delayed cerebral ischaemia
and improve functional outcomes in patients with SAH. This observation merits further
prospective investigation of the use of CPP-guided treatment in patients with SAH.
