Fluid therapy in neurotrauma: basic and clinical concepts

Area of Science:

• Neurosurgery
• Emergency Medicine
• Critical Care Medicine

Background:

• Traumatic brain injury (TBI) presents significant challenges for emergency physicians and neurosurgeons.
• TBI is a major public health concern requiring effective management strategies.
• Optimal care for TBI patients necessitates understanding prehospital and perioperative therapeutic approaches.

Purpose of the Study:

• To review the literature on fluid therapy in patients with traumatic brain injury.
• To discuss the history and physiology of fluid preparations.
• To explore fluid therapy considerations in TBI, particularly in the context of decompressive craniectomy.

Main Methods:

• Literature review of fluid therapy in traumatic brain injury.
• Examination of fluid resuscitation strategies for combined TBI and hemorrhagic shock.
• Discussion of fluid management in TBI patients, including those undergoing decompressive craniectomy.

Main Results:

• Rapid crystalloid infusion is standard for TBI and hemorrhagic shock to restore blood volume and pressure.
• Fluid management in brain injury patients is a critical and complex topic.
• Current literature provides insights into historical and physiological aspects of fluid preparations.

Conclusions:

• Understanding fluid therapy is essential for optimal management of TBI patients.
• Specific fluid strategies are crucial for patients with TBI, especially those with combined hemorrhagic shock.
• Further discussion is warranted regarding fluid use in TBI and decompressive craniectomy.