Comparison of hydroxyethyl starch colloids with crystalloids for surgical patients: A systematic review and meta-analysis

European Journal of Anaesthesiology
Mohamed RaimanR N Rodseth

Abstract

Fluid therapy is one of the most ubiquitous medical therapeutic interventions. There is a debate over whether colloids or crystalloids are better for fluid resuscitation. Recent large trials and meta-analyses suggest no mortality benefit and possible harm with hydroxyethyl starch (HES) use. However, these trials were conducted in critically ill and septic patients and their applicability to perioperative patients has been challenged. We aimed to evaluate the impact of HES use in scheduled and elective surgical patients. Systematic review and meta-analysis of randomised controlled trials (RCTs). Only RCTs comparing the use of the synthetic colloid HES with any crystalloid in adults undergoing noncardiac surgery (up to 24 h postop) were considered eligible. For each eligible trial, we extracted the outcomes of all-cause mortality within 90 days, length of hospital stay, major infectious complications, acute kidney injury (AKI) and renal replacement therapy (RRT). We identified 1555 citations, selected 90 for full-text evaluation, and identified 13 eligible RCTs. Trials were small (n = 20 to 202) with low event rates. There was a trend to increased mortality with HES within 90 days [13/373 vs. 3/368; risk ratio 2.97; 95% confidenc...Continue Reading

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Citations

Feb 11, 2018·Annals of Intensive Care·Joana GameiroJosé António Lopes
Jun 23, 2019·Journal of Veterinary Emergency and Critical Care·Gaby van Galen, Gayle Hallowell
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
May 7, 2016·European Journal of Anaesthesiology·Mohamed RaimanReitze N Rodseth
Mar 20, 2019·Anesthesiology·Harriet W Hopf, Candice Morrissey
May 3, 2016·European Journal of Anaesthesiology·Maria J ColominaJuan V Llau
Mar 24, 2016·Intensive Care Medicine·Christian ErtmerPhilippe Van Der Linden
Mar 21, 2016·Anaesthesia·H S NaS H Do
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Dec 7, 2018·European Journal of Anaesthesiology·Philippe Van der LindenSibylle Kietaibl
Dec 7, 2018·European Journal of Anaesthesiology·Kirsten C RasmussenTom Pedersen
Nov 17, 2016·Current Medical Research and Opinion·N El GkotmiM S Elisaf
May 8, 2020·Vox Sanguinis·Robert B KlandermanAlexander P J Vlaar
Oct 10, 2020·Der Anaesthesist·M von der ForstB H Siegler
Mar 12, 2020·Anaesthesia Critical Care & Pain Medicine·Laurent Muller
Sep 27, 2021·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Benedict MorathMarcin Zaradzki

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