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However given these effects bothdirectly on ICP and indirectly on CPP via theeffects on MAP, these agents should be used cau-tiously in patients at risk for alterations in ICP orthose who may not tolerate decreases in CPP. Optimal timing for surgical interven-tion is while lung function is satisfactory andbefore cardiomyopathy becomes severe enoughto risk arrhythmia under anesthesia (Cobb anglebetween 30° and 50°)

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