|
Characteristics of included randomized trials |
|||||
| Trial |
n† |
Indication |
Fluid Regimen‡ |
Follow-Up |
Endpoints |
|
|
|||||
| Falk et al., 1988 [9] |
12 |
Septic shock |
6% HES 450/0.7 or 5% albumin to 15 mm Hg target PAWP |
24 h |
Coagulation |
| Rackow et al., 1989 [7] |
20 |
Severe sepsis and systemic hypoperfusion |
10% HES 200/0.5 or 5% albumin to 15 mm Hg target PAWP or 2000 mL maximum |
45 min |
Cardiorespiratory function and coagulation |
| Boldt et al., 1995 [17,18] |
30 |
Sepsis after major surgery |
10% HES 200/0.5 or 20% albumin to 12–16 mm Hg target CVP, PCWP or both |
5 days |
Endothelial-related coagulation and platelet function |
| Boldt et al., 1996 [19] |
30 |
Sepsis secondary to major general surgery |
10% HES 200/0.5 or 20% albumin to 12–18 mm Hg target PCWP |
5 days |
Cardiorespiratory and circulatory variables |
| Boldt et al., 1996 [20] |
42 |
Sepsis secondary to major surgery |
6% HES 200/0.5, 20% albumin or pentoxifylline |
5 days |
Circulating soluble adhesion molecules |
| Boldt et al., 1996 [21] |
28 |
Sepsis secondary to major surgery |
10% HES 200/0.5 or 20% albumin to 10–15 mm Hg target PCWP |
5 days |
Circulatory variables |
| Boldt et al., 1998 [22] |
150 |
Postoperative sepsis |
10% HES 200/0.5 or 20% albumin to 12–15 mm Hg target PCWP |
5 days |
Hemodynamics, laboratory data and organ function |
| Asfar et al., 2000 [23] |
34 |
Sepsis and hypovolemia in ventilated and hemodynamically controlled patients |
500 mL 6% HES 200/0.62 or 4% succinylated modified fluid gelatin |
60 min |
Hemodynamics and gastric mucosal acidosis |
| Schortgen et al., 2001 [24] |
129 |
Severe sepsis or septic shock |
6% HES 200/0.62 up to 4 days or 80 mL·kg-1 cumulative dose or 3% gelatin |
34 days |
ARF |
| Molnár et al., 2004 [25] |
30 |
Septic shock with hypovolemia and acute lung injury |
6% HES 200/0.5 or 4% modified fluid gelatin to achieve ITBVI > 900 mL·m-2 |
60 min |
Hemodynamics, EVLW and oxygenation |
| Palumbo et al., 2006 [26] |
20 |
Severe sepsis in mechanically ventilated patients |
6% HES 130/0.4 or 20% albumin to maintain PCWP of 15–18 mm Hg |
5 days |
Hemodynamic and oxygenation parameters |
| Brunkhorst et al., 2008 [27] |
537 |
Severe sepsis or septic shock |
10% HES 200/0.5 (to 20 mL·kg-1·day-1 limit) or Ringer's lactate to target of ≥ 8 mm Hg CVP |
90 days |
Morbidity and mortality |
|
Abbreviations: ARF, acute renal failure; CVP, central venous pressure; EVLW, extravascular lung water; HES, hydroxyethyl starch; ICU, intensive care unit; ITBVI, intrathoracic blood volume index; PAWP, pulmonary arterial wedge pressure; PCWP, pulmonary capillary wedge pressure †For trials with more than one indication, includes only patients with sepsis. ‡HES solutions specified by molecular weight/molar substitution. | |||||
Wiedermann BMC Emergency Medicine 2008 8:1 doi:10.1186/1471-227X-8-1 |
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