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Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.
Patients with severe sepsis assigned to fluid resuscitation with HES 130/0.42 had an increased risk of death at day 90 and were more likely to require renal-replacement therapy, as compared with those receiving Ringer's acetate.
Lower versus higher hemoglobin threshold for transfusion in septic shock.
Among patients with septic shock, mortality at 90 days and rates of ischemic events and use of life support were similar among those assigned to blood transfusion at a higher hemoglobin threshold and those assigned at a lower threshold; the latter group received fewer transfusions.
Hydroxyethyl starch 130/0.38-0.45 versus crystalloid or albumin in patients with sepsis: systematic review with meta-analysis and trial sequential analysis
The effects of fluid therapy with hydroxyethyl starch 130/0.38-0.45 versus crystalloid or albumin increased the use of renal replacement therapy and transfusion with red blood cells, and resulted in more serious adverse events in patients with sepsis.
Consecutive thrombelastography clot strength profiles in patients with severe sepsis and their association with 28-day mortality: a prospective study.
The ICU admission TEG MA remained constant for several days in patients with severe sepsis and hypocoagulable MA independently predicted 28-day mortality.
Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial
A protocol restricting resuscitations fluid successfully reduced volumes of resuscitation fluid compared with a standard care protocol in adult ICU patients with septic shock, pointing towards benefit with fluid restriction.
Bleeding and risk of death with hydroxyethyl starch in severe sepsis: post hoc analyses of a randomized clinical trial
Treatment with HES increased the risk of bleeding which was associated with increased risk of death, and HES-induced bleeding complications may negatively affect outcome in patients with severe sepsis.
Predictive value of NGAL for use of renal replacement therapy in patients with severe sepsis
The predictive value of plasma and urine neutrophil gelatinase‐associated lipocalin (NGAL) for use of renal replacement therapy (RRT) and acute kidney injury (AKI) is not established in patients with
Red blood cell transfusion in septic shock - clinical characteristics and outcome of unselected patients in a prospective, multicentre cohort
The decision to transfuse patients with septic shock was likely affected by disease severity and bleeding, but haemoglobin level was the only measure that consistently differed between transfused and non-transfused patients.
Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis
Compared with liberal strategies, restrictive transfusion strategies were associated with a reduction in the number of red blood cell units transfused and number of patients being transfused, but mortality, overall morbidity, and myocardial infarction seemed to be unaltered.
Clinical review: Predictive value of neutrophil gelatinase-associated lipocalin for acute kidney injury in intensive care patients
NGAL seems to have reasonable value in predicting use of renal replacement therapy but not mortality, and the heterogeneity in study design and results made it difficult to evaluate the value of NGAL to predict AKI in intensive care patients.