Table 12.

Neuroprotective Goals. Hb = Hemoglobin; Na = Sodium; P₅₀ = Oxygen-Hemoglobin Dissociation Curve; MAP = Mean Arterial Pressure; SBP = Systolic Blood Pressure; CPP = Cerebral Perfusion Pressure; PbtO2 = Partial pressure of brain tissue oxygen; PEEP = Positive End-Expiratory Pressure; PT = Prothrombin Time; aPTT = Activated Partial Thromboplastin Time; PaO₂ = Arterial Oxygen Partial Pressure; RASS = Richmond Agitation-Sedation Scale; RR = Respiratory Rate; SpO₂ = Peripheral Oxygen Saturation; PaCO₂ =Arterial Carbon Dioxide Partial Pressure; TV = Tidal Volume.

●Maintain head elevation at 30–45° with the body axis in neutral alignment

●RASS -5

●Maintain temperature between 36 and 37 °C

●Hb target ≥9 g/dL

●Maintain Na 135-155 mEq/dL

●Keep normal levels of other electrolytes

●Keep lactate levels less than 2 mmol/L

●Blood pH 7.35-7.45

●P50 target 26-28

●MAP >80 mmHg and SBP >100 mmHg

●CPP between 60 and 70 mmHg and varies according to autoregulatory status

●Maintain blood glucose between 110 and 170 mg/dL

●Keep normal levels of coagulation tests: INR less than 1.5, platelets more than 100,000/UL and fibrinogen >150 mg

●PaO2 80-110 mmHg

●SpO2 > 94%

●PaCO2 35-45 mmHg

●ICP should be maintained at < 22 mmHg, or further reduced if abnormal ICP waveform patterns are observed

●Maintain PbtO2 >20 mmHg whenever monitoring is available

●Maintain venous jugular oxygen saturation (SjO2) > 55%

●Neuroprotective Ventilatory Parameters

○RR: 10-20 bpm

○PaCO2: 35 - 45 mmHg

○TV: 5 - 7 ml/kg

○PEEP: 5 cmH2O

○PaO2 > 60 mmHg

○SpO2 > 94%