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Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 10-16

'ROSE concept' of fluid management: Relevance in neuroanaesthesia and neurocritical care

Department of Anaesthesia, P D Hinduja Hospital and MRC, Mumbai, Maharashtra, India

Correspondence Address:
Joseph N Monteiro
D61, Nirvana Society, Bhagoji Keer Marg, Mahim, Mumbai - 400 016, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2348-0548.197435

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Fluid therapy in neurosurgical patients aims to restore intravascular volume, optimise haemodynamic parameters and maintain tissue perfusion, integrity and function. The goal is to minimise the risk of inadequate cerebral perfusion pressure and to maintain good neurosurgical conditions. However, fluid management in brain-injured patients has several distinctive features compared with non-brain-injured critically ill patients. The ROSE concept advocates the restriction of fluids, which is consistent with the prevention of a 'tight brain' in neurosurgery. Whether this imbalance in fluid management studies between different types of brain injuries is a reflection of differences in clinical relevance of fluid management is not clear. Further randomised controlled trials in the future are essential in subarachnoid haemorrhage and traumatic brain injury patients who are critical and need long-term Intensive Care Unit stay to elucidate and define the role and relevance of the ROSE concept in neuroanaesthesia and neurocritical care.

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