Early Positive Fluid Balance as a Clinical Marker of Systemic Capillary Leak and Clazosentan Intolerance After Aneurysmal Subarachnoid Hemorrhage

Early positive fluid balance was a strong independent predictor of clazosentan discontinuation and was associated with poor functional outcomes. Early postoperative fluid balance may serve as a practical bedside marker of clazosentan intolerance and fluid-retentive physiological response, potentially involving increased vascular permeability. Goal-directed fluid management targeting euvolemia during the first 72 h may help optimize tolerability and enhance the therapeutic efficacy of clazosentan.