Hydroxyethyl starch for resuscitation

被引：17

作者：

Haase, Nicolai ^{[1
]}

Perner, Anders ^{[1
]}

机构：

[1] Copenhagen Univ Hosp, Rigshosp, Dept Intens Care, DK-2100 Copenhagen, Denmark

来源：

CURRENT OPINION IN CRITICAL CARE | 2013年 / 19卷 / 04期

关键词：

haemostasis; hydroxyethyl starch; kidney; mortality; resuscitation; CRITICALLY-ILL PATIENTS; PROSPECTIVE RANDOMIZED-TRIAL; IMPAIR BLOOD-COAGULATION; CARDIAC-SURGERY; SEVERE SEPSIS; 6-PERCENT HYDROXYETHYLSTARCH; FLUID RESUSCITATION; SEQUENTIAL-ANALYSIS; VOLUME REPLACEMENT; INTENSIVE-CARE;

D O I：

10.1097/MCC.0b013e3283632de6

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose of reviewResuscitation with hydroxyethyl starch (HES) is controversial. In this review, we will present the current evidence for the use of HES solutions including data from recent high-quality randomized clinical trials.Recent findingsMeta-analyses of HES vs. control fluids show clear signals of harm including adverse effects on kidney and haemostatic function, and trends towards increased mortality. These results are mainly based on recent large randomized clinical trials comparing tetrastarch (HES 130/0.4 and HES 130/0.42) vs. crystalloid in patients in the ICU. Trials in trauma and surgical patients cannot adequately assess safety issues and do not show clear benefit with the use of HES. There is currently no firm evidence that tetrastarch has better safety profile than the former HES solutions.SummaryThere is no evidence for an overall beneficial effect of HES in any subgroup of critically ill patients, but there are clear signs of harm. As safer alternatives exist, we recommend that HES is no longer used in critically ill patients.

引用

页码：321 / 325

页数：5

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