MCP๋กœ ์—ฐ๊ฒฐ โ†’

๊ณ„์‚ฐ ์ž…๋ ฅ

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๊ฒฐ๊ณผ

๋‡Œ๊ด€๋ฅ˜์•• (CPP)
83.33
mmHg
ํ‰๊ท ๋™๋งฅ์•• (MAP) 93.33 mmHg
๋‘๊ฐœ๋‚ด์•• (ICP) 10 mmHg

๋‡Œ๊ด€๋ฅ˜์••(CPP)์ด๋ž€?

๋‡Œ๊ด€๋ฅ˜์••(CPP, Cerebral Perfusion Pressure)์€ ๋‡Œ๋กœ ํ˜ˆ์•ก, ์ฆ‰ ์‚ฐ์†Œ๋ฅผ ๊ณต๊ธ‰ํ•˜๋Š” ๋ฐ ์ž‘์šฉํ•˜๋Š” ์ˆœ(net) ์••๋ ฅ ์ฐจ์ด๋ฅผ ๋งํ•ฉ๋‹ˆ๋‹ค. ๋‡Œ๋กœ ํ˜ˆ์•ก์„ ๋ฐ€์–ด ๋ณด๋‚ด๋Š” ํ‰๊ท ๋™๋งฅ์••(MAP)์—์„œ ์ด ํ๋ฆ„์„ ๊ฐ€๋กœ๋ง‰๋Š” ๋‘๊ฐœ๋‚ด์••(ICP)์„ ๋บ€ ๊ฐ’์œผ๋กœ ์ •์˜๋ฉ๋‹ˆ๋‹ค. ์ถฉ๋ถ„ํ•œ CPP๋ฅผ ์œ ์ง€ํ•˜๋Š” ๊ฒƒ์€ ๋‡Œํ—ˆํ˜ˆ์„ ์˜ˆ๋ฐฉํ•˜๋Š” ๋ฐ ํ•„์ˆ˜์ ์ด๋ฉฐ, ํŠนํžˆ ์™ธ์ƒ์„ฑ ๋‡Œ์†์ƒ, ๋‡Œ์กธ์ค‘, ๋‘๊ฐœ๋‚ด์••์ด ์ƒ์Šนํ•œ ํ™˜์ž์—์„œ ๋งค์šฐ ์ค‘์š”ํ•ฉ๋‹ˆ๋‹ค.

Diagram of cerebral perfusion pressure as the difference between mean arterial pressure pushing blood into the skull and intracranial pressure resisting it
Cerebral perfusion pressure is the net pressure driving blood flow to the brain (MAP minus ICP).

๊ณ„์‚ฐ๊ธฐ ์‚ฌ์šฉ ๋ฐฉ๋ฒ•

ํ™˜์ž์˜ ์ˆ˜์ถ•๊ธฐ ํ˜ˆ์••(SBP), ์ด์™„๊ธฐ ํ˜ˆ์••(DBP), ๊ทธ๋ฆฌ๊ณ  ์ธก์ •๋œ ๋‘๊ฐœ๋‚ด์••(ICP)์„ ๋ชจ๋‘ mmHg ๋‹จ์œ„๋กœ ์ž…๋ ฅํ•˜์„ธ์š”. ๊ณ„์‚ฐ๊ธฐ๋Š” ๋จผ์ € MAP๋ฅผ ์ถ”์ •ํ•œ ๋’ค ์—ฌ๊ธฐ์„œ ICP๋ฅผ ๋นผ์„œ CPP๋ฅผ ์‚ฐ์ถœํ•ฉ๋‹ˆ๋‹ค. ์„ฑ์ธ์˜ ๊ฒฝ์šฐ ์™ธ์ƒ์„ฑ ๋‡Œ์†์ƒ ์ดํ›„ ๋Œ€๋žต 60~70 mmHg์˜ CPP๋ฅผ ๋ชฉํ‘œ๋กœ ๊ถŒ์žฅํ•˜๋Š” ๊ฒฝ์šฐ๊ฐ€ ๋งŽ์ง€๋งŒ, ์‹ค์ œ ๋ชฉํ‘œ์น˜๋Š” ํ™˜์ž๋ณ„๋กœ ๊ฐœ๋ณ„ํ™”ํ•ด ์„ค์ •ํ•ฉ๋‹ˆ๋‹ค.

๊ณต์‹ ์„ค๋ช…

์ด ๋„๊ตฌ๋Š” ๋‘ ๊ฐ€์ง€ ํ‘œ์ค€ ๊ณต์‹์„ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค. ํ‰๊ท ๋™๋งฅ์••์€ $$\text{MAP} = \text{DBP} + \frac{\text{SBP} - \text{DBP}}{3}$$์œผ๋กœ ์ถ”์ •ํ•ฉ๋‹ˆ๋‹ค. ์‹ฌ์žฅ์€ ์‹ฌ์ฃผ๊ธฐ์˜ ์•ฝ 3๋ถ„์˜ 2๋ฅผ ์ด์™„๊ธฐ์—์„œ ๋ณด๋‚ด๊ธฐ ๋•Œ๋ฌธ์— ์ด ์‹์€ ์ด์™„๊ธฐ ํ˜ˆ์••์— ๋” ํฐ ๊ฐ€์ค‘์น˜๋ฅผ ๋‘ก๋‹ˆ๋‹ค. ์ด๋ ‡๊ฒŒ ๊ตฌํ•œ ๊ฐ’์œผ๋กœ ๋‡Œ๊ด€๋ฅ˜์••์€ $$\text{CPP} = \text{MAP} - \text{ICP}$$๋กœ ๊ณ„์‚ฐ๋ฉ๋‹ˆ๋‹ค.

Formula breakdown showing CPP equals MAP minus ICP and MAP derived from systolic and diastolic pressure
CPP is calculated by subtracting ICP from MAP, where MAP is derived from systolic and diastolic blood pressure.

๊ณ„์‚ฐ ์˜ˆ์‹œ

์–ด๋–ค ํ™˜์ž์˜ SBP๊ฐ€ 120 mmHg, DBP๊ฐ€ 80 mmHg, ICP๊ฐ€ 10 mmHg๋ผ๊ณ  ๊ฐ€์ •ํ•ด ๋ณด๊ฒ ์Šต๋‹ˆ๋‹ค. $$\text{MAP} = 80 + \frac{120 - 80}{3} = 80 + 13.33 = 93.33 \text{ mmHg}$$๊ฐ€ ๋ฉ๋‹ˆ๋‹ค. ๋”ฐ๋ผ์„œ $$\text{CPP} = 93.33 - 10 = 83.33 \text{ mmHg}$$์ด๋ฉฐ, ์ด๋Š” ์ •์ƒ ๋ฒ”์œ„ ์•ˆ์— ์žˆ์Šต๋‹ˆ๋‹ค.

์ž์ฃผ ๋ฌป๋Š” ์งˆ๋ฌธ

์ •์ƒ CPP๋Š” ์–ผ๋งˆ์ธ๊ฐ€์š”? ์„ฑ์ธ์˜ ๊ฒฝ์šฐ ์•ฝ 60~80 mmHg์˜ CPP๊ฐ€ ์ผ๋ฐ˜์ ์œผ๋กœ ์ ์ ˆํ•˜๋‹ค๊ณ  ๋ด…๋‹ˆ๋‹ค. 50~60 mmHg ๋ฏธ๋งŒ์œผ๋กœ ๋–จ์–ด์ง€๋ฉด ๋‡Œํ—ˆํ˜ˆ์˜ ์œ„ํ—˜์ด ์ปค์ง‘๋‹ˆ๋‹ค.

MAP๋ฅผ ์ธก์ •ํ•˜์ง€ ์•Š๊ณ  ์ถ”์ •ํ•˜๋Š” ์ด์œ ๋Š” ๋ฌด์—‡์ธ๊ฐ€์š”? ๋™๋งฅ๊ด€(arterial line)์„ ์‚ฝ์ž…ํ•˜๋ฉด MAP๋ฅผ ์ง์ ‘ ์ธก์ •ํ•  ์ˆ˜ ์žˆ์ง€๋งŒ, SBP/DBP๋ฅผ ์ด์šฉํ•œ ์ถ”์ • ๋ฐฉ์‹์€ ์ปคํ”„(ํ˜ˆ์••๊ณ„)๋กœ๋งŒ ์ธก์ • ๊ฐ€๋Šฅํ•œ ์ƒํ™ฉ์—์„œ ๊ฐ„ํŽธํ•ด ๋„๋ฆฌ ์“ฐ์ž…๋‹ˆ๋‹ค.

์ž„์ƒ์  ํŒ๋‹จ์„ ๋Œ€์‹ ํ•  ์ˆ˜ ์žˆ๋‚˜์š”? ์•„๋‹™๋‹ˆ๋‹ค. ์ด ๊ณ„์‚ฐ๊ธฐ๋Š” ๊ต์œก์šฉ ๋ณด์กฐ ๋„๊ตฌ์ผ ๋ฟ์ด๋ฉฐ, ์น˜๋ฃŒ ๋ชฉํ‘œ์น˜๋Š” ๋ฐ˜๋“œ์‹œ ์ž๊ฒฉ์„ ๊ฐ–์ถ˜ ์˜๋ฃŒ์ง„์ด ํ™˜์ž๋งˆ๋‹ค ์ง์ ‘ ์„ค์ •ํ•ด์•ผ ํ•ฉ๋‹ˆ๋‹ค.

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