Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 1901 - 1911 |
| Number of pages | 11 |
| Journal | New England Journal of Medicine |
| Volume | 367 |
| Issue number | 20 |
| DOIs | |
| Publication status | Published - 2012 |
| Externally published | Yes |
Cite this
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Hydroxyethyl starch or saline for fluid resuscitation in intensive care. / Myburgh, John A; Finfer, Simon R; Bellomo, Rinaldo; Billot, Laurent; Cass, Alan; Gattas, David J; Glass, Parisa; Lipman, Jeff; Liu, Bette; McArthur, Colin; McGuinness, Shay P; Rajbhandari, Dorrilyn; Taylor, Colman B; Webb, Steven A R.
In: New England Journal of Medicine, Vol. 367, No. 20, 2012, p. 1901 - 1911.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Hydroxyethyl starch or saline for fluid resuscitation in intensive care
AU - Myburgh, John A
AU - Finfer, Simon R
AU - Bellomo, Rinaldo
AU - Billot, Laurent
AU - Cass, Alan
AU - Gattas, David J
AU - Glass, Parisa
AU - Lipman, Jeff
AU - Liu, Bette
AU - McArthur, Colin
AU - McGuinness, Shay P
AU - Rajbhandari, Dorrilyn
AU - Taylor, Colman B
AU - Webb, Steven A R
PY - 2012
Y1 - 2012
N2 - The safety and efficacy of hydroxyethyl starch (HES) for fluid resuscitation have not been fully evaluated, and adverse effects of HES on survival and renal function have been reported. METHODS: We randomly assigned 7000 patients who had been admitted to an intensive care unit (ICU) in a 1:1 ratio to receive either 6 HES with a molecular weight of 130 kD and a molar substitution ratio of 0.4 (130/0.4, Voluven) in 0.9 sodium chloride or 0.9 sodium chloride (saline) for all fluid resuscitation until ICU discharge, death, or 90 days after randomization. The primary outcome was death within 90 days. Secondary outcomes included acute kidney injury and failure and treatment with renal-replacement therapy. RESULTS: A total of 597 of 3315 patients (18.0 ) in the HES group and 566 of 3336 (17.0 ) in the saline group died (relative risk in the HES group, 1.06; 95 confidence interval [CI], 0.96 to 1.18; P = 0.26). There was no significant difference in mortality in six predefined subgroups. Renal-replacement therapy was used in 235 of 3352 patients (7.0 ) in the HES group and 196 of 3375 (5.8 ) in the saline group (relative risk, 1.21; 95 CI, 1.00 to 1.45; P = 0.04). In the HES and saline groups, renal injury occurred in 34.6 and 38.0 of patients, respectively (P = 0.005), and renal failure occurred in 10.4 and 9.2 of patients, respectively (P = 0.12). HES was associated with significantly more adverse events (5.3 vs. 2.8 , P
AB - The safety and efficacy of hydroxyethyl starch (HES) for fluid resuscitation have not been fully evaluated, and adverse effects of HES on survival and renal function have been reported. METHODS: We randomly assigned 7000 patients who had been admitted to an intensive care unit (ICU) in a 1:1 ratio to receive either 6 HES with a molecular weight of 130 kD and a molar substitution ratio of 0.4 (130/0.4, Voluven) in 0.9 sodium chloride or 0.9 sodium chloride (saline) for all fluid resuscitation until ICU discharge, death, or 90 days after randomization. The primary outcome was death within 90 days. Secondary outcomes included acute kidney injury and failure and treatment with renal-replacement therapy. RESULTS: A total of 597 of 3315 patients (18.0 ) in the HES group and 566 of 3336 (17.0 ) in the saline group died (relative risk in the HES group, 1.06; 95 confidence interval [CI], 0.96 to 1.18; P = 0.26). There was no significant difference in mortality in six predefined subgroups. Renal-replacement therapy was used in 235 of 3352 patients (7.0 ) in the HES group and 196 of 3375 (5.8 ) in the saline group (relative risk, 1.21; 95 CI, 1.00 to 1.45; P = 0.04). In the HES and saline groups, renal injury occurred in 34.6 and 38.0 of patients, respectively (P = 0.005), and renal failure occurred in 10.4 and 9.2 of patients, respectively (P = 0.12). HES was associated with significantly more adverse events (5.3 vs. 2.8 , P
UR - http://www.nejm.org/doi/full/10.1056/NEJMoa1209759
U2 - 10.1056/NEJMoa1209759
DO - 10.1056/NEJMoa1209759
M3 - Article
VL - 367
SP - 1901
EP - 1911
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 20
ER -