The impact of a highly visible display of cerebral perfusion pressure on outcome in individuals with cerebral aneurysms

BACKGROUND: Nurses' ability to rapidly detect decreases in cerebral perfusion pressure (CPP), which may contribute to secondary brain injury, may be limited by poor visibility of CPP displays. OBJECTIVE: To evaluate the impact of a highly visible CPP display on the functional outcome in individuals with cerebral aneurysms. METHODS: Patients with cerebral aneurysms (n = 100) who underwent continuous CPP monitoring were enrolled and randomized to beds with or without the additional CPP display. Six-month outcome was assessed. RESULTS: Functional outcome was not significantly different between control and intervention groups after controlling for initial neurologic condition (odds ratio.904, 95% confidence interval 0.317 to 2.573). However, greater time below CPP thresholds (55 to 70 mm Hg) was significantly associated with poorer outcome (P =.005 to.010). CONCLUSIONS: Although the enhanced CPP display was not associated with significantly better outcome, longer periods of CPP below set levels were associated with poorer outcome.