June - 2012
| Next | Showing Journal 1 of 9 |
 Hydroxyethyl Starch 130/0.4 versus Ringers Acetate in Severe Sepsis6S Trial Group and the Scandinavian Critical Care Trials Group New Eng J Med, 2012, DOI: 10.1056/NEJMoa1204242 This page is only available to Crit-IQ subscribers. To view the rest of this review and gain access to our vast array of critical care teaching tools including podcasts, vodcasts, modules, exam preparation tools, teaching aids and much more, login here, or Become a Member to register |
June |
Previous Comments
| Both CHEST and 6S were performed in patients requiring resuscitation fluids (largely at the discretion of the ICU team) while in the ICU. These are important trials that suggest HES should not be used in this context, given the apparent dose-dependent toxicity of HES to kidneys, and on mortality. However, there isn't evidence to support or refute the use of HES in other contexts such as resuscitation in the emergency department in trauma or severe sepsis, for instance. So we need to be careful not to over-extrapolate these trials. That notwithstanding, as John Myburgh says, HES should no longer be used outside the context of a clinical trial until there is evidence to support its use. | |
| Ian-10 Jan, 2014 02:08:44 PM | |
Comment
This prospective multi-center parallel RCT trial of HES 130/0.4 vs Ringers in critically ill patients with severe sepsis reports an increase in 90-day mortality (51 vs 43%, RR 1.17 95% CI 1.01 to 1.36), requirement for renal replacement therapy (16 vs 10%, RR 1.35, 95% CI 1.01 to 1.80) and severe...