Hydroxyethyl Starch for Fluid Management in Sepsis
Author Information
Author(s): Wiedermann Christian J
Primary Institution: Central Hospital of Bolzano, Bolzano, Italy
Hypothesis
The aim of this systematic review was to evaluate current evidence on the effectiveness and safety of hydroxyethyl starch for fluid management in sepsis.
Conclusion
Hydroxyethyl starch increases the risk of acute renal failure among patients with sepsis and may also reduce the probability of survival.
Supporting Evidence
- Hydroxyethyl starch increased the incidence of acute renal failure compared with gelatin.
- Mortality was higher in patients receiving more than 22 mL·kg-1 hydroxyethyl starch per day.
- The review included twelve randomized trials involving a total of 1062 patients.
Takeaway
This study found that using hydroxyethyl starch in sepsis patients can lead to kidney problems and might make it harder for them to survive.
Methodology
The review included computer searches of MEDLINE, EMBASE, and the Cochrane Library for randomized clinical trials comparing hydroxyethyl starch with other fluids in sepsis patients.
Potential Biases
The trials included varied in design and endpoints, which may introduce bias.
Limitations
The evidence reviewed cannot necessarily be applied to other clinical indications.
Participant Demographics
The trials included patients with severe sepsis or septic shock, with a median of 30 patients per trial.
Statistical Information
P-Value
p<0.001
Confidence Interval
1.13–5.83
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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