Fluid management concepts for severe neurological illness

Abstract

As the possibility grows closer that we can monitor the physiological parameters with direct relevance for neurological outcomes and the various complications associated with neurocritical illness, we may finally move away from static therapy recommendations, and toward individualized, precise therapy. Although we believe therapy should ultimately be individualized rather than standardized, it is clear that the monitoring tools and analytical methods used ought to be standardized to facilitate appropriately powered, prospective clinical outcome trials.

Passive leg raising in brain injury patients within the neurointensive care unit. A prospective trial

“…for patients with critical neurological illness [2]. Current guidelines on fluid management in brain injured patients recommend using fluid balances or central venous pressure (CVP) to guide vol ume status [3].…”

“…Volume management and its influence on outcome in neurocritical care patients, however, have been particularly elusive. Volume status is a major determinant of CBF and PbtO 2 , and a well-considered fluid management strategy is essential for patients with critical neurological illness [ 2 ].Current guidelines on fluid management in brain-injured patients recommend using fluid balances or central venous pressure (CVP) to guide volume status [ 3 ]. Fluid administration aims to increase cardiac output (CO).…”