Debendra Kumar Tripathy
The aim of fluid administration in neurosurgery patients is to maintain adequate cerebral flow and oxygenation. Too much or too less fluid infusion can be detrimental for the patient outcome. The goal directed fluid management in major surgery and critically patient has been extensively studied and generally guided by haemodynamic monitoring. The same principles may not be applicable to in all neurosurgery patients, as cerebral perfusion physiology depends on many factors. With this background we did a concise review of neurophysiology, guidelines and recent clinical trials for goal directed fluid therapy in neurosurgery patients. In this review, we found current understanding of neurophysiology suggests normovolumia approach for most of the neurosurgery patients. But the evedence are inconclusive for the measurable end points against which fluid can be titrated.