{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:25:01Z","timestamp":1782516301321,"version":"3.54.5"},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nPerioperative fluid management is critical in neurosurgery as over perfusion can lead to brain edema whereas under perfusion may lead to brain hypoperfusion or ischemia. We aimed to determine the effectiveness of intraoperative goal-directed fluid therapy (GDFT) in patients undergoing intracranial surgeries.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nWe searched MEDLINE, Cochrane, and PubMed databases and forward-backward citations for studies published between database inception and February 22, 2024. Randomized controlled trials where intraoperative GDFT was performed in neurosurgery and compared to the conventional regime were included in the study. GDFT was compared with the conventional regime as per primary outcomes \u2013 total intraoperative fluid requirement, serum lactate, hemodynamics, brain relaxation, urine output, serum biochemistry, and secondary outcomes \u2013 intensive care unit and hospital length of stay. The quality of evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO (CRD42024518816).<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nOf 75 records identified, eight were eligible, the majority of which had a low to moderate risk of overall bias. In four studies, more fluid was given in the control group. No difference in postoperative lactate values was noted in 50% of studies. In the remaining 50%, lactate was more in the control group. Three out of four studies did not find any significant difference in the incidence of intraoperative hypotension, and four out of six studies did not find a significant difference in vasopressor requirement. The majority of studies did not show significant differences in urine output, brain relaxation, and length of stay between both groups. None found any difference in acid base status or electrolyte levels.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nGDFT, when compared to the conventional regime in neurosurgery, showed that the total volume of fluids administered was lesser in the GDFT group with no increase in serum lactate. There was no difference in the hemodynamics, urine output, brain relaxation, urine output, length of stay, and biochemical parameters.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_412_2024","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T09:16:02Z","timestamp":1720170962000},"page":"233","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intraoperative goal-directed fluid therapy in neurosurgical patients: A systematic review"],"prefix":"10.25259","volume":"15","author":[{"given":"Chayanika","family":"Kutum","sequence":"first","affiliation":[{"name":"Department ofAnesthesiology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Lakhe","sequence":"additional","affiliation":[{"name":"Department ofNeurosurgery, All India Institute of Medical Sciences, Nagpur, Maharashtra, India,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niraj","family":"Ghimire","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nepalgunj Medical College, Nepalgunj, Nepal,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil Kumar","family":"BC","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Begum","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, BLK Max Hospital, New Delhi, Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karandeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neuroanesthesia, Max Saket Hospital, New Delhi, Delhi, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2024,7,5]]},"reference":[{"key":"10.25259\/SNI_412_2024\/ref-1","doi-asserted-by":"crossref","first-page":"311","DOI":"10.4103\/sja.SJA_689_17","article-title":"Intraoperative fluid management: Past and future, where is the evidence?","volume":"12","author":"Al-Ghamdi","year":"2018","journal-title":"Saudi J Anaesth"},{"key":"10.25259\/SNI_412_2024\/ref-2","first-page":"25305088","article-title":"Perioperative microdialysis in meningioma surgery: Correlation of cerebral metabolites with clinical outcome","volume":"12","author":"Balaka","year":"2014","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_412_2024\/ref-3","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/ANA.0000000000000332","article-title":"Elevated intraoperative serum lactate during craniotomy is associated with new neurological deficit and longer length of stay","volume":"29","author":"Brallier","year":"2017","journal-title":"J Neurosurg Anesthesiol"},{"key":"10.25259\/SNI_412_2024\/ref-4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/ALN.0b013e318225b80a","article-title":"Assessing the diagnostic accuracy of pulse pressure variations for the prediction of fluid responsiveness: A \u201cgray zone\u201d approach","volume":"115","author":"Cannesson","year":"2011","journal-title":"Anesthesiology"},{"key":"10.25259\/SNI_412_2024\/ref-5","first-page":"209","article-title":"Clinical review: Goal-directed therapy-what is the evidence in surgical patients? 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