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REVIEW ARTICLES
Year : 2019  |  Volume : 3  |  Issue : 1  |  Page : 15-18

Fluid administration strategies in traumatic brain injury


1 Department of Critical Care, Neurocritical Care Unit, King Saud Medical City, Riyadh, KSA
2 Department of Surgery, Rady Faculty of Health Science, University of Manitoba, Winnipeg, MB, Canada
3 Department of Critical Care, Neurocritical Care Unit, King Saud Medical City, Riyadh, KSA; Department of Critical Care, Keck School of Medicine, USC, LA, CA, USA

Correspondence Address:
Abdulrahman Alharthy
Department of Critical Care, Neurocritical Care Unit, King Saud Medical City, Riyadh
KSA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2543-1854.259472

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Fluid restriction strategies may reduce morbidity and mortality in critical care patients and are currently trending as preliminary data showed encouraging results. A positive fluid balance was related to increase morbidity and mortality in a variety of disorders (i.e., sepsis, acute respiratory distress syndrome, and postsurgical cases) as well as resulted in an increased rate of complications observed in the intensive care unit setting. Traumatic brain injury (TBI) has been managed thus far in terms of fluid resuscitation under the concept of general trauma resuscitation recommendations that favored euvolemia above all fluid balance states. Notwithstanding, scarce data exist to clarify details about fluid management strategies in TBI such as the desirable fluid balance per se and/or its impact on patients' outcomes. We, therefore, reviewed previously published data and concluded in an observational manner (by creating a visual display model) that a highly positive and/or a negative fluid balance may have a detrimental impact on the prognosis of TBI patients. Accordingly, well-designed randomized controlled trials are clearly required to investigate further and in detail the most efficacious fluid administration strategies in TBI contributing thus in the rapidly expanding field of neurocritical care.


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