A safe zone between 60 and 70 mm Hg could be identified for adults ≤65 years, provided AR was active and ICP was ≤25 mm Hg. In the present study, the CPP pressure-time burden associated with poor outcome was visualized. Episodes with ICP >25 mm Hg were associated with poor outcome regardless of CPP. The AR status predominantly affected the transition curve for insults of low CPP. When combining the two plots, a safe CPP zone between 60 and 70 mm Hg could be delineated-however, only for AR active insults. Analysis of episodes of high CPP again showed a time-intensity dependent association with outcome. In adults ≤65 years, an almost exponential transition curve separates the episodes of CPP associated with better outcomes from the episodes of low CPP associated with worse outcomes, indicating that lower CPP could only be tolerated for a brief time.

The relationship of episodes of CPP below or above a certain threshold for certain duration with the 6-month Glasgow Outcome Score was visualized separately for episodes of active or deficient autoregulation (AR). The analysis was based on prospectively collected minute-by-minute intracranial pressure (ICP) and blood pressure data and outcome from 259 adult patients. The purpose of the present study is to visualize the association of intensity and duration of episodes below or above CPP thresholds and outcome. The definition of cerebral perfusion pressure (CPP) secondary insults in severe traumatic brain injury remains unclear.

Xenon adults only password 2018