Fig. 6

Long-term monitoring of PRx in a patient after TBI. ICP was first elevated to 20 mmHg and then decreased, showing some fluctuations over 7 days of monitoring. PRx had parabolic distribution along the recorded range of CPP (from 60 to 100 mmHg). The minimum of this parabola indicates ‘optimal CPP’ from the whole 7-day period (90 mmHg in this case—as compared with above 65–70 mmHg, advised by guidelines—which illustrates well that CPP-oriented management must be individualised; it is not true that one shoe size is good for everybody). Moreover, such a fitting of an ‘optimal curve’ may be repeated in time, based on data from the past 4 h. This enables prospective detection and tracing of ‘optimal CPP’ and targeting current CPP at its current optimal value, which may change in a course of intensive care. CPP cerebral perfusion pressure, ICP intracranial pressure, PRx pressure reactivity index