Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions

Ripollés, Javier; Espinosa, Á.; Casans, Rubén; Tirado, Ana; Abad, Alfredo; Fernández, Cristina; Calvo, J.

doi:10.1016/j.bjane.2014.07.018

Cited by 11 publications

(8 citation statements)

References 49 publications

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“…Cochrane database analysis showed increased need for renal replacement therapy and increased mortality with use of starch solutions in critically ill patients . Another meta‐anlaysis found increased mortality with starch solutions without any increased need for RRT . A recent systematic review did not find any additional benefits with starch and hence recommended against its use in the perioperative setting .…”

Section: Discussionmentioning

confidence: 99%

Hydroxyethyl starch and kidney function: A retrospective study in patients undergoing therapeutic plasma exchange

Radhakrishnan

Batra

Periyavan

et al. 2017

J of Clinical Apheresis

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Section: Discussionmentioning

confidence: 99%

Hydroxyethyl starch and kidney function: A retrospective study in patients undergoing therapeutic plasma exchange

Radhakrishnan

Batra

Periyavan

et al. 2017

J of Clinical Apheresis

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“…This meta-analysis found that there was no difference in postoperative complications when using either crystalloids or colloids; however, GDFT with colloids was associated with a trend toward increased mortality. 67 Continued debate exists surrounding the appropriate fluid type in GDFT and ERAS protocols. Due to their ability to increase intravascular volume more reliably and for a longer period of time than crystalloids, colloids have earned a place in many ERAS pathways.…”

Section: Fluid Typementioning

confidence: 99%

Perioperative Fluid Management in the Enhanced Recovery after Surgery (ERAS) Pathway

Zhu

Agarwala

Bao

2019

Clinics in Colon and Rectal Surgery

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Fluid management is an essential component of the Enhanced Recovery after Surgery (ERAS) pathway. Optimal management begins in the preoperative period and continues through the intraoperative and postoperative phases. In this review, we outline current evidence-based practices for fluid management through each phase of the perioperative period. Preoperatively, patients should be encouraged to hydrate until 2 hours prior to the induction of anesthesia with a carbohydrate-containing clear liquid. When mechanical bowel preparation is necessary, with modern isoosmotic solutions, fluid repletion is not necessary. Intraoperatively, fluid therapy should aim to maintain euvolemia with an individualized approach. While some patients may benefit from goal-directed fluid therapy, a restrictive, zero-balance approach to intraoperative fluid management may be reasonable. Postoperatively, early initiation of oral intake and cessation of intravenous therapy are recommended.

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“…Recent meta‐analyses suggest a slightly increased risk of mortality associated to HES administration to critically ill patients, mainly linked to higher doses of HES or daily fluid balance, and influenced by baseline comorbidity . Mortality shows as a rather late finding with separation of survival curves occurring around day 20 .…”

Section: Current Published Human Research Information and Datamentioning

confidence: 99%

Hydroxyethyl starches in equine medicine

Galen

Hallowell

2019

J Vet Emergen Crit Care

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Objective To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use. Data sources Veterinary and human peer‐reviewed medical literature including scientific reviews, meta‐analyses, and original research articles. Human data synthesis Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people. Equine veterinary data synthesis The rationale for HES use in horses is mainly extrapolated from human medicine, and very limited studies in horses are available. There is limited evidence suggesting a superiority of volume expansion effects of HES over crystalloids. The potential for HES to increase and maintain COP is well supported, but there is no evidence that maintaining or increasing plasma COP influences outcome, tissue edema formation, or rates of complications that potentially relate to edema formation. HES induce dose–dependent changes in coagulopathic parameters, but there is no evidence that HES causes clinical coagulopathies. Insufficient data are available on other adverse effects such as acute kidney injury, or mortality in horses. The use of HES should be restricted in septic patients, but may still have some use in cases of hemorrhagic shock resuscitation, hypoalbuminemia, or perioperative fluid replacement. Conclusion The evidence supporting the use of HES in horses is weak due to lack of species‐specific investigations. Acknowledging species differences, the use of HES should be judicious, yet with some recognition of its benefits in particular cases. More research is necessary to improve knowledge on use of HES in horses and to establish better future recommendations.

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Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions

Cited by 11 publications

References 49 publications

Hydroxyethyl starch and kidney function: A retrospective study in patients undergoing therapeutic plasma exchange

Hydroxyethyl starch and kidney function: A retrospective study in patients undergoing therapeutic plasma exchange

Perioperative Fluid Management in the Enhanced Recovery after Surgery (ERAS) Pathway

Hydroxyethyl starches in equine medicine

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