One trial found that it helped to correct the negative sodium balance, and the other reported a reduced need for fluids and improved sodium levels using this mineralocorti- coid.305,306 A similar randomized, placebo-controlled trial showed reduced natriuresis and a lower rate of hyponatremia in aSAH patients treated with hydrocortisone.307 The value of albumin as an efficient volume expander during the vasospasm phase in aSAH has been suggested in uncontrolled studies, but there is no clear evidence of its superiority over crystalloids in patients with aSAH.308 Fever is the most common medical complication in aSAH.309 The presence of fever of noninfectious (central) origin has been associated with severity of injury, amount of hemorrhage, and development of vasospasm, and it may represent a marker of a systemic inflammatory state triggered by blood and its byproducts.310 312 Analysis of data from a prospectively collected registry of aSAH indicated that fever was independently associated with worse cognitive outcome in survivors of aSAH.313,314 Improved functional outcome with effective control of fever has been reported.315 Both animal studies and human case series have demonstrated an association between elevated blood glucose concentration and poor outcome after ischemic brain injury.316 323 The mecha- nisms explaining such an association in human beings are unclear. Data obtained from consecutive patients with aSAH using historical controls to compare aggressive versus stan- dard management of hyperglycemia suggest that effective glucose control after aSAH can significantly reduce the risk of poor outcome in these patients.324 Nevertheless, even serum glucose levels within the normal range may be asso- ciated with brain energy metabolic crisis and lactate-pyruvate ratio elevation in patients with poor-grade aSAH.325 Anemia is common after aSAH and may compromise brain oxygen delivery.326 Transfusion of red blood cells in anemic patients with aSAH results in a significant rise in cerebral oxygen delivery and a reduction in oxygen extraction ratio.327 Data obtained from prospective registries of patients with aSAH suggest that higher hemoglobin values are associated with improved outcomes after aSAH.328,329 Nevertheless, thresholds for blood transfusion have been dictated in a nonsystematic manner and have therefore varied widely. 