Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.
@article{Perner2012HydroxyethylS1, title={Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.}, author={Anders Perner and Nicolai Haase and Anne Berit Guttormsen and Jyrki J. Tenhunen and Gudmundur K. Klemenzson and Anders Aneman and Kristian R{\o}rb{\ae}k Madsen and Morten Hylander M{\o}ller and Jeanie M Elkj{\ae}r and Lone M. Poulsen and Asger Bendtsen and Robert Winding and Morten Steensen and Pawel Berezowicz and Peter S{\o}e-Jensen and Morten H. Bestle and Kristian Strand and J{\o}rgen Wiis and Jonathan O White and Klaus J Thornberg and Lars Quist and Jonas Nielsen and Lasse H{\o}gh Andersen and Lars Broks{\o} Holst and Katrin Maria Thormar and Anne-Lene Kj{\ae}ldgaard and Maria Louise Fabritius and Frederik Mondrup and Frank Christian Pott and Thea Palsgaard M{\o}ller and Per Winkel and J{\o}rn Wetterslev}, journal={The New England journal of medicine}, year={2012}, volume={367 2}, pages={ 124-34 } }
BACKGROUND
Hydroxyethyl starch (HES) [corrected] is widely used for fluid resuscitation in intensive care units (ICUs), but its safety and efficacy have not been established in patients with severe sepsis.
METHODS
In this multicenter, parallel-group, blinded trial, we randomly assigned patients with severe sepsis to fluid resuscitation in the ICU with either 6% HES 130/0.42 (Tetraspan) or Ringer's acetate at a dose of up to 33 ml per kilogram of ideal body weight per day. The primary outcome…
1,225 Citations
Hydroxyethyl starch or saline for fluid resuscitation in intensive care.
- MedicineThe New England journal of medicine
- 2012
In patients in the ICU, there was no significant difference in 90-day mortality between patients resuscitated with 6% HES (130/0.4) or saline, however, more patients who received resuscitation with HES were treated with renal-replacement therapy.
Bleeding and risk of death with hydroxyethyl starch in severe sepsis: post hoc analyses of a randomized clinical trial
- MedicineIntensive Care Medicine
- 2013
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.
Hydroxyethyl starch in sepsis.
- MedicineDanish medical journal
- 2014
A randomised clinical trial is one of several high-quality trials in critically ill patients with and without sepsis that now provide evidence that the use of tetrastarch impairs kidney function and haemostasis and may even increase mortality.
Early fluid resuscitation with hydroxyethyl starch 130/0.4 (6%) in severe burn injury: a randomized, controlled, double-blind clinical trial
- MedicineCritical Care
- 2013
There was no evidence that early fluid resuscitation with balanced HES 130/0.4 (6%) in addition to lactated Ringer’s solution would lead to a volume-sparing effect in severe burn injury and the findings that early renal function, incidence of ARDS, length of stay, and mortality were not negatively influenced by HES.
Risks of Hydroxyethyl Starch 130/0.4 in Cardiac Surgery
- MedicineJournal of pharmacy practice
- 2014
Meta-analyses of randomized trials have demonstrated that excess mortality, renal failure, and bleeding are class effects of HES solutions, and HES was also an independent risk factor for mortality in a retrospective hospital discharge database study of 19 578 cardiac surgery patients.
Albumin replacement in patients with severe sepsis or septic shock.
- MedicineThe New England journal of medicine
- 2014
In patients with severe sepsis, albumin replacement in addition to crystalloids, as compared with crystalloids alone, did not improve the rate of survival at 28 and 90 days.
Hydroxyethyl starch - friend or foe?
- Medicine
- 2016
A narrative review of recent literature was undertaken to establish the current utility and efficacy of HES in clinical practice and aims at increasing awareness amongst anesthetists and critical care specialist about correct and careful fluid administration.
Impact of 6% balanced hydroxyethyl starch following cardiopulmonary bypass on renal function: a retrospective study
- MedicineJournal of Cardiothoracic Surgery
- 2020
The moderate dose administration of HES in the postoperative period following cardiac surgery might be associated with the risk of acute kidney injury, however, it was not associated with serious adverse outcomes such as new RRT or mortality.
Hydroxyethyl starches in the intensive care unit
- Medicine
- 2014
The recently published evidences on the benefit-risk ratio of HES are discussed and the reasons that led to such a delay before health alert was triggered are discussed.
The Dilemma for Using Hydroxyethyl Starch Solutions for Perioperative Fluid Management
- Medicine
- 2016
There are sufficient data to suggest that HES has similar risks also in these patients and should therefore be avoided, and no definitive, large-scale randomized controlled trials with patient-relevant outcomes and long-term follow-up exist in this population.
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