Title

Beyond the waveform: FloTrac for brain protection and DCI in aSAH

Authors

Bhavana Pinnaka1¹, Vasudha Singhal², Ishrat Yousuf³,*, Poonam Rani⁴, L. Yalamanchali Sindhura⁵ & Harsh Sapra⁶

Affiliation

¹Department of Critical Care Medicine, KIMS ICON Hospitals, Visakhapatnam Andhra Pradesh, India; ²Department of Neuroanaesthesia and Neurocritical care, Max Smart Hospital, Delhi, India; ³Department of Neuroanaesthesia, Sher-e-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India; ⁴Department of Anaesthesia, Aadesh Medical College and Hospital, Mohri, Haryana, India; ⁵Department of Anaesthesia, Cloudnine Hospital, Hitech City, Hyderabad, Telangana, India; ⁶Department of Neuranaesthesia and Neurocritical care, Medanta - The Medicity, Gurugram, Haryana, India; *Corresponding author

Email

Bhavana Pinnaka - E-mail: bhavanachowdary88@gmail.com
Vasudha Singhal - E-mail: vasudha_sarab@yahoo.com
Ishrat Yousuf - E-mail: eshratusuf90@gmail.com
Poonam Rani - E-mail: prathore646@gmail.com
Yalamanchali L. Sindhura - E-mail: sindhuraones@gmail.com
Harsh Sapra - E-mail: harsh.sapra@medanta.org

Article Type

Research Article

Date

Received September 1, 2026; Revised September 30, 2026; Accepted September 30, 2026, Published September 30, 2026

Abstract

Delayed cerebral ischaemia is the leading preventable cause of morbidity after aneurysmal subarachnoid haemorrhage and this study evaluated FloTrac-guided goal-directed fluid therapy. A prospective randomized trial enrolled 68 patients assigned to conventional CVP-guided management (n=34) or FloTrac-guided therapy (n=34), with delayed cerebral ischaemia as the primary outcome. Delayed cerebral ischaemia occurred less often with FloTrac-guided therapy (17.6% vs. 32.4%), while angiographic vasospasm was absent in the FloTrac group (0% vs. 32.3%; P<0.001). FloTrac-guided therapy produced better functional recovery, fewer readmissions and shorter ICU and hospital stays, although most differences were not statistically significant. Thus, FloTrac-guided goal-directed therapy showed clinically meaningful benefits and this may improve neurological outcomes after aneurysmal subarachnoid haemorrhage.

Keywords

Aneurysmal subarachnoid haemorrhage (aSAH), cardiac output monitoring, delayed cerebral ischaemia, FloTrac, goal directed therapy, vasospasm

Citation

Pinnakal et al. Bioinformation 22(9): 5690-5694 (2026)

Edited by

Ruby Singh

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.