Long-term outcomes in patients with severe sepsis randomised to resuscitation with hydroxyethyl starch 130/0.42 or Ringer’s acetate

Perner, Anders; Haase, Nicolai; Winkel, Per; Guttormsen, Anne Berit; Tenhunen, Jyrki; Klemenzson, Guðmundur; Müller, R; Åneman, Anders; Wetterslev, Jørn

doi:10.1007/s00134-014-3311-y

Cited by 56 publications

(50 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Expert consensus on, and implementation of, standardized outcome definitions and core outcome sets is fundamental to reducing bias when comparing effects across trials. (57) Not specifically stated (26,65,69,70,76) Day 28 and 90 (54) Not specifically stated (72) Key: IMV, invasive mechanical ventilation; NIV, noninvasive mechanical ventilation; SBT, spontaneous breathing trial; UAB, unassisted breathing. Some trials measured more than one endpoint.…”

Section: Resultsmentioning

confidence: 99%

How Outcomes Are Defined in Clinical Trials of Mechanically Ventilated Adults and Children

Blackwood

Clarke

McAuley

et al. 2014

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

How Outcomes Are Defined in Clinical Trials of Mechanically Ventilated Adults and Children

Blackwood

Clarke

McAuley

et al. 2014

Am J Respir Crit Care Med

View full text Add to dashboard Cite

“…Optimal fl uid resuscitation is recognized as a critical component, and studies have addressed the crystalloid/colloid debate. [11][12][13][14][15] However, limited data guide fl uid management in the ICU in a timesensitive manner. Multiple studies have demonstrated harm with standardizing liberal fluid resuscitation, notably when given beyond the initial hours of EGDT.…”

mentioning

confidence: 99%

Increased Fluid Administration in the First Three Hours of Sepsis Resuscitation Is Associated With Reduced Mortality

Lee

Ramar

Park

et al. 2014

CHEST

102

View full text Add to dashboard Cite

show abstract

“…In a follow-up of the 6S trial, Perner and colleagues reported that the long-term mortality rate did not differ in patients with severe sepsis receiving starches when compared to crystalloids (mean follow-up 22 months, range 13-36); there was a trend toward fewer days alive and out of hospital in the starches group [24 % (0-87) vs. 63 % (0-90); P = 0.07] [13]. Among factors that may cause the deleterious effect of starches, tissue accumulation has been found to be frequent, rapid, nearly ubiquitous, persistent, and associated with adverse events [14].…”

Section: Resuscitation Fluidmentioning

confidence: 99%

Focus on acute kidney injury and fluids

2016

Self Cite

View full text Add to dashboard Cite

An acute deterioration of kidney function, currently known as acute kidney injury (AKI), frequently develops in ICU patients and is always bad news. In this overview we will highlight recent findings related to its diagnosis, epidemiology, and extracorporeal treatment. Epidemiology of AKIThe AKI-EPI study, a worldwide cross-sectional study on the occurrence of acute kidney injury (AKI) in the first week in intensive care unit (ICU), found AKI in 57 % of the 1800 included patients. AKI severity was associated with adverse patient and kidney outcome at hospital discharge [1]. Analysis of a large cohort (32,045) in a single medical center confirmed the high prevalence (74.5 %) and further illustrated that both AKI severity and duration and the criteria used to define it (creatinine, urine output, or both) had significant impact on short-and long-term outcomes [2]. Another large cohort study in 580 patients with out-of-hospital cardiac arrest found severe AKI in 43 % of the patients and the association with mortality but not with neurological outcome [3]. Last, it must be noted that first validation of the Kidney Disease Improving Global Outcomes (KDIGO) criteria was performed in a large pediatric population [4]. Assessment of renal prognosis and of renal functionSeveral studies demonstrated limits of usual renal dysfunction criteria and of biomarkers in assessing renal function or predicting renal prognosis. First, short episodes of oliguria in ICU patients are frequent and do not always predict subsequent AKI by creatinine criteria. Legrand et al. explored whether AKI biomarkers could predict worsening of kidney function (WKF) in 111 critically ill patients with first episode of oliguria. Interestingly, although plasma neutrophil gelatinase-associated lipocalin (NGAL) might improve the prediction of WKF, the biomarker had a similar performance to serum creatinine [5]. Furthermore, the follow-up of the furosemide stress test study found limited performance of biomarkers to predict WKF, which were largely outperformed by the furosemide stress test [6].The gold standard for glomerular filtration rate (GFR) determination is inulin clearance, but this cannot be measured easily. Carlier and co-workers compared inulin clearance with creatinine clearance and several creatinine and/or cystatin C-based GFR equations in 68 critically ill patients with stable kidney function. As a result of tubular secretion of creatinine, measured creatinine clearance resulted in a slight overestimation of GFR while creatinine-based equations had the worst performance with overestimation of the true GFR; the overestimation increased with hospital stay [7]. This confirms previous findings showing increasing differences between discharge estimated GFR (eGFR) and creatinine clearance with increasing ICU stay in both AKI and non-AKI patients. Reduced creatinine excretion resulting from muscle loss was the main determinant of this difference [8]. Since cystatin is not influenced by muscle mass, the cystatin-based equations did not share the hospi...

show abstract

Long-term outcomes in patients with severe sepsis randomised to resuscitation with hydroxyethyl starch 130/0.42 or Ringer’s acetate

Abstract: The long-term mortality rates did not differ in patients with severe sepsis assigned to HES 130/0.42 versus Ringer's acetate, but we could not reject a 24% relative increased or a 4% relative decreased mortality at 1 year with HES at the 95% confidence level.

Cited by 56 publications

References 29 publications

How Outcomes Are Defined in Clinical Trials of Mechanically Ventilated Adults and Children

How Outcomes Are Defined in Clinical Trials of Mechanically Ventilated Adults and Children

Increased Fluid Administration in the First Three Hours of Sepsis Resuscitation Is Associated With Reduced Mortality

Focus on acute kidney injury and fluids

Contact Info

Product

Resources

About