• Saliha Ergezen, Eveline J Wiegers, Eva Klijn, and Mathieu van der Jagt.
• Department of Adults Intensive Care, Erasmus Medical Center, Rotterdam, the Netherlands - s.ergezen@erasmusmc.nl.
• Minerva Anestesiol. 2023 Oct 1; 89 (10): 936944936-944.

AbstractAdequate fluid therapy in the acute brain injured (ABI) patient is essential for maintaining an adequate brain and systemic physiology and preventing intra- and extracranial complications. The target of euvolemia, implying avoidance of both hypovolemia and fluid overloading (or "hypervolemia," by definition associated with fluid extravasation leading to tissue edema) is of key importance. Primary brain injury can be aggravated by secondary brain injury and systemic deterioration through diverse pathways which can challenge appropriate fluid management, e.g. neuroendocrine and electrolyte disorders, stress cardiomyopathy (also known as cardiac stunning) and neurogenic pulmonary edema. This is an updated expert opinion aiming to provide a practical overview on fluid therapy in the ABI patient, partly based on more recent work and stressing the fact that intravenous fluids should be regarded as drugs, with their inherent potential for both benefit and (unintended) harm.

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