Fluid management in patients undergoing neurosurgery

Abstract

Fluid management is an important component of perioperative care for patients undergoing neurosurgery. The primary goal of fluid management in neurosurgery is the maintenance of normovolemia and prevention of serum osmolarity reduction. To maintain normovolemia, it is important to administer fluids in appropriate amounts following appropriate methods, and to prevent a decrease in serum osmolarity, the choice of fluid is essential. There is considerable debate about the choice and optimal amounts of fluids administered in the perioperative period. However, there is little high-quality clinical research on fluid therapy for patients undergoing neurosurgery. This review will discuss the choice and optimal amounts of fluids in neurosurgical patients based on the literature, recent issues, and perioperative fluid management practices.

Accuracy of Real Time Continuous Glucose Monitoring during Different Liquid Solution Challenges in Healthy Adults: A Randomized Controlled Cross-Over Trial

“…When considering the Ringer and sodium chloride solutions used in this study, it is worth mentioning that the theoretical osmolarity of these solutions was 308 and 309 mOsm•L −1 , respectively, which is only slightly higher than the osmolarity of normal serum [17]. However, since even small changes in osmolarity can be expected to have a marked effect on water transfer [17,18], it is possible that sensor performance might also be impaired by these changes, although the absolute fluid intake in this study was rather small [19].…”

Effect of different fluid therapies on postoperative pulmonary complications in neurosurgical patients

“…The primary objective of fluid management in neurosurgical anesthesia is to avoid cerebral injury resulting from insufficient cerebral perfusion and to provide an optimal operative setting. Hence, it is essential to preserve hemodynamic stability and provide adequate cerebral perfusion pressure during neurosurgical procedures [2] . Hemodynamic changes and disturbances in electrolyte levels often arise during neurosurgery due to the frequent use of diuretic medications to alleviate elevated intracranial pressure and swelling.…”

“…Hemodynamic changes and disturbances in electrolyte levels often arise during neurosurgery due to the frequent use of diuretic medications to alleviate elevated intracranial pressure and swelling. Furthermore, the administration of substantial quantities of fluids may be necessary, depending on the nature of the operation, to address preoperative hypovolemia and perioperative unstable hemodynamics, as well as to avoid cerebral vasospasm [2] . Neurosurgery involves managing patients by ensuring the stability of their internal environment, particularly by maintaining a balanced blood flow to the brain and providing sufficient oxygen supply.…”