title: The impact of a highly visible display of cerebral perfusion pressure on outcome in individuals with cerebral aneurysms.
abstract: 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.
authors.affiliation: Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98195-7266, USA.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Kirkness
authors.forename: Robert L
authors.initials: RL
authors.lastname: Burr
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Cain
authors.forename: David W
authors.initials: DW
authors.lastname: Newell
authors.forename: Pamela H
authors.initials: PH
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D003626:Data Display; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D007362:Intensive Care Units; D002532:Intracranial Aneurysm / Q000150:complications / Q000451:nursing*; D007427:Intracranial Pressure; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D019095:Point-of-Care Systems; D016037:Single-Blind Method; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000451:nursing*; D016019:Survival Analysis; D016896:Treatment Outcome