A 54-year-old man presents with altered mental status and upper GI bleeding. His past medical history is significant for cirrhosis secondary to non-alcoholic fatty liver disease. He is admitted to the ICU. His blood pressure is 110/60 mm Hg and heart rate is 105 bpm. His serum ammonia level is 110 mcg/dL, about 2X higher than his baseline. His upper GI bleed is managed endoscopically with clipping of 2 small varices. His encephalopathy improved minimally, and an intracranial pressure monitor (ICP) was placed, demonstrating an ICP between 12 and 15 mmHg. Despite adequate volume resuscitation, his blood pressure begins to fall, and ceftriaxone is begun for suspected bloodstream infection. Which mean arterial pressure (MAP) goal would allow improved end-organ perfusion, including cerebral perfusion?
