Fluids, Electrolytes, and Nutrition in the Critically Ill Patient with Neurotrauma

Fluid, electrolytes, and nutrition are vital components in the management of critically ill patients. Patients with neurotrauma present certain challenges and considerations, specifically with the need to mitigate secondary injury while addressing the systemic sequelae of trauma. With regard to crystalloid administration, isotonic normal saline remains the choice fluid, especially in patients with traumatic brain injury. The preference for saline formulations extend to hyperosmolar therapy as well, with hypertonic saline becoming, in general, preferential to mannitol. Electrolyte disturbances can emerge in critically ill patients. Optimizing nutrition requires a multidisciplinary approach as patients with especially traumatic brain injury have unique needs.