Long-Term Outcome Call into Question the Benefit of Positive Fluid Balance and Colloid Treatment After Aneurysmal Subarachnoid Hemorrhage

Excerpt

Aneurysmal subarachnoid hemorrhage (SAH) has a high mortality and morbidity, and long-term outcome is determined by the functional capacity of the patient. Preventing delayed cerebral ischemia that will result in delayed ischemic neurological deficits (DINDs) is a paramount treatment goal during the post-hemorrhage period. There is still controversy regarding the best strategies. While therapeutic induction of hypertension, hypervolemia, and hemodilution (“Triple-H therapy”) is the most commonly accepted treatment, uncertainty remains, among others, whether colloids versus crystalloids should be utilized, and whether maintaining a positive fluid balance in patients with evidence for vasospasm improves long-term functional outcome. …