Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials

Wiedermann, Christian J.; Dunzendorfer, Stefan; Gaioni, L; Zaraca, Francesco; Joannidis, Michael

doi:10.1186/cc9308

Cited by 124 publications

(76 citation statements)

References 55 publications

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“…5 Odeljenje bolničke farmacije, Bolnica Valjevo, Valjevo, Srbija; 6 Institut za kardiovaskularnu hirurgiju "Dedinje", Beograd, Srbija KRATAK SADRŽAJ Cilj ra da Mo gu ći ri zik od po ve ća nja mor ta li te ta zbog pri me ne hu ma nih al bu mi na (HA) kod operi sa nih bo le sni ka još ni je utvr đen. Cilj ove stu di je bio je pro ce na udru že no sti sto pe mor ta li te ta ope ri sa nih bo le sni ka sa dru gim po ka za te lji ma kva li te ta zdrav stve nih uslu ga, po tro šnjom HA i hi drok si e til-skro ba (HES).…”

Section: Discussionunclassified

“…In trauma and sepsis, cardiac index and oxygenation were higher after the administration of HES than hyperoncotic HA, but survival was unaffected by hyperoncotic HA. Furthermore, Wiedermann et al [6] suggested in their meta-analysis that renal effects of colloid solutions appeared to be dependent on the type of colloids. Hyperoncotic HA exerts renoprotection while hyperoncotic HES shows nephrotoxicity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is 28-day follow-up period enough for examining the mortality after resuscitation with human albumin?

Vukovic¹,

Gvozdenovic²,

Jakovljević³

et al. 2014

Hosp Pharm Int Multi J

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SUMMARYObjective The potential risk of mortality increase due to the use of human albumin (HA) in surgical patients has not been determined yet. The aim of the study was to evaluate the association of mortality rate of surgical patients with other indicators of the quality of health services and consumption of HA and hydroxyethyl starch (HES). MethodsThe study of a time series at the surgical department analyzed monthly indicators of the quality of health services. The monthly consumption of HA and HES is shown as a number of HA or HES bottles consumed in the intensive care unit (ICU) or outside the ICU. Autoregressive integrated moving average (ARIMA) model was used for the statistical analysis.Results For the total mortality rate, four significantly predictors in moving average model were identified. The total mortality rates for each next month were significantly directly dependent on the unobserved random error from the current and previous month. Number of operated patients showed an indirect effect on the total mortality rate. Number of HA bottles consumed in the ICU, mortality rate of operated patients and patients without operation were directly associated with the increased total mortality rate.Conclusions Follow-up period for examination of the mortality from resuscitation with HA in a heterogeneous surgical population can not be less than two months. ARIMA can be extremely useful in determining a total period of time when all mortality due to the application of certain drug in a particular population will be manifested.

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Section: Discussionunclassified

Section: Introductionmentioning

confidence: 99%

Is 28-day follow-up period enough for examining the mortality after resuscitation with human albumin?

Vukovic¹,

Gvozdenovic²,

Jakovljević³

et al. 2014

Hosp Pharm Int Multi J

View full text Add to dashboard Cite

show abstract

“…Additionally, this study did not use the correct patient numbers from the original ALBIOS study publication [48]. In contrast to hyperoncotic HES solution, no negative impact of albumin on renal function could be shown [49].…”

Section: Albuminmentioning

confidence: 99%

State of the art in fluid and volume therapy

et al. 2017

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“…In a large multi-centre European study of 822 critically ill adults with shock receiving fluid resuscitation, use of hypertonic natural and synthetic colloids was associated with a several fold increased risk for AKI and death [50] . A recent systematic review found divergent findings for use of hyperoncotic colloids for resuscitation and subsequent risk of AKI [51] . In this meta-analysis of 7 trials including 1220 patients, hyperoncotic albumin was associated with reduced risk (OR = 0.24, P < 0.001); whereas hyperoncotic HES solutions were associated with increased risk for AKI (OR = 1.92; 95%CI: 1.31-2.81, P < 0.001).…”

Section: Colloid Solutionsmentioning

confidence: 99%

Controversies in fluid therapy: Type, dose and toxicity

McDermid

Raghunathan

Romanovsky

et al. 2014

WJCCM

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Fluid therapy is perhaps the most common intervention received by acutely ill hospitalized patients; however, a number of critical questions on the efficacy and safety of the type and dose remain. In this review, recent insights derived from randomized trials in terms of fluid type, dose and toxicity are discussed. We contend that the prescription of fluid therapy is context-specific and that any fluid can be harmful if administered inappropriately. When contrasting ''crystalloid vs colloid'', differences in efficacy are modest but differences in safety are significant. Differences in chloride load and strong ion difference across solutions appear to be clinically important. Phases of fluid therapy in acutely ill patients are recognized, including acute resuscitation, maintaining homeostasis, and recovery phases. Quantitative toxicity (fluid overload) is associated with adverse outcomes and can be mitigated when fluid therapy based on functional hemodynamic parameters that predict volume responsiveness and minimization of non-essential fluid. Qualitative toxicity (fluid type), in particular for iatrogenic acute kidney injury and metabolic acidosis, remain a concern for synthetic colloids and isotonic saline, respectively. Physiologically balanced crystalloids may be the ''default'' fluid for acutely ill patients and the role for colloids, in particular hydroxyethyl starch, is increasingly unclear. We contend the prescription of fluid therapy is analogous to the prescription of any drug used in critically ill patients.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Fluid therapy; Resuscitation; Critical illness; Peri-operative; Toxicity; Saline; Crystalloid; Colloid Core tip: Fluid therapy is exceedingly common in acutely ill patients; however, numerous questions on the efficacy and safety of fluid therapy in terms of the type and dose remain. Fluid therapy prescription is contextspecific and any fluid type can be harmful if administered inappropriately. When considering crystalloids versus colloids, differences in efficacy are modest but the risk of kidney toxicity and bleeding complications with hydroxyethyl starch appear more significant. The differences in chloride load across crystalloid solutions appears to have physiologic and clinically important effects, in particular for contributing to hyperchloremic metabolic acidosis, kidney injury and greater utilization of renal replacement therapy associated with 0.9% saline. Fluid therapy should be viewed as analogous to the prescription of any drug in acutely ill patients.McDermid RC, Raghunathan K, Romanovsky A, Shaw AD, Bagshaw SM. Controversies in fluid therapy: Type, dose and toxicity.

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Hyperoncotic colloids and acute kidney injury: a meta-analysis of randomized trials

Cited by 124 publications

References 55 publications

Is 28-day follow-up period enough for examining the mortality after resuscitation with human albumin?

Is 28-day follow-up period enough for examining the mortality after resuscitation with human albumin?

State of the art in fluid and volume therapy

Controversies in fluid therapy: Type, dose and toxicity

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