Open AccessPeri-operative fluid management during neurosurgical procedures
Author(s) -
Carlos Darcy Alves Bersot,
Rafael Mercante Linhares,
Carolina Araujo Barbosa,
José Eduardo Guimarães Pereira
Publication year - 2021
Publication title -
nepal journal of neuroscience
Language(s) - English
Resource type - Journals
eISSN - 1813-1956
pISSN - 1813-1948
DOI - 10.3126/njn.v18i2.33373
Subject(s) - medicine , hypovolemia , furosemide , anesthesia , intravascular volume status , resuscitation , diabetes insipidus , cerebral blood flow , cerebral perfusion pressure , hyponatremia , cerebral edema , hemodynamics , blood volume
The management of fluids and electrolytes in neurosurgical patients aims to reduce the risk of cerebral oedema, reduce ICP and at the same time maintain haemodynamic stability and cerebral perfusion. Neurosurgical patients commonly receive diuretics (mannitol and furosemide), developing complications such as bleeding and diabetes insipidus. These patients may require large volumes of intravenous fluids and even blood transfusions for volume resuscitation, treatment of cerebral vasospasm, correction of preoperative dehydration or maintenance of haemodynamic stability. Goal-oriented therapy is recommended in neurological patients, with the aim of maintaining circulating volume and tolerating the changes induced by anaesthesia (vasodilation and myocardial depression).