Normal Saline Vrs Balanced i.v. Fluids in Neurosurgery
Normal Saline Vrs Balanced i.v. Fluids in Neurosurgery
The purpose of this study was to investigate whether the balanced fluids therapy change
 plasma osmolality in neurosurgical procedures due to brain tumors, meningeomas and
 arterio-venous malformation.
Normal saline or 0.9% sodium chloride solution is the most commonly used intravenous fluid
 worldwide and its composition are 154 mmol Na+ and 154 mmol Cl- per litter with osmolality of
 308 mOsmol/L. That composition is not "normal" because plasma contains potassium in range
 between 137-146 mmol/L, and chloride in range between 98-106 mmol/L, with plasma osmolality
 of 280-295 mOsmol/kg. Recently published data suggested detrimental effects of chloride rich
 fluids on renal blood flow and glomerular filtration rate, urine output and acute kidney
 injury. One alternative to saline solution is a buffered, balanced, crystalloid solution with
 an electrolyte composition similar to plasma and osmolality between 286-295 mOsmol/L. Someone
 could indicate that such balanced solutions are not suitable for neurosurgical patients
 because of a possible impact on the brain edema development.
Inclusion Criteria:

 -  Patients with brain tumor, meningeomas and vascular malformation.

 Exclusion Criteria:

 -  Patients with signs of elevated intracranial pressure; History of kidney disease,
 History of heart disease