A systematic review examined the effects of fluid volume management on outcomes in patients with moderate to severe traumatic brain injury (TBI). The analysis of 12 studies with 9,184 TBI patients found that euvolemic fluid management significantly reduced the risk of mortality and improved the likelihood of favorable neurological outcomes compared with both restrictive and liberal fluid strategies. Additionally, euvolemia was associated with lower risks of acute kidney injury and refractory intracranial hypertension, as well as shorter duration of mechanical ventilation compared with liberal fluid regimens. The results suggest that targeting euvolemic fluid balance may enhance clinical outcomes in TBI care. Further RCTs are needed to assess euvolemic fluid management protocols in neurocritical care and guide clinical practice, the researchers conclude.