Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care
New England Journal of Medicine, Volume 367, No. 20, Year 2012
Notification
URL copied to clipboard!
Description
BACKGROUND: 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<0.001). CONCLUSIONS: In patients in the ICU, there was no significant difference in 90-day mortality between patients resuscitated with 6% HES (130/0.4) or saline. However, more patients who received resuscitation with HES were treated with renal-replacement therapy. (Funded by the National Health and Medical Research Council of Australia and others; CHEST ClinicalTrials.gov number, NCT00935168.) Copyright © 2012 Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Myburgh, John A.
Australia, Sydney
George Institute for Global Health
Australia, Sydney
Unsw Sydney
Australia, Sydney
St George Hospital
Australia, Sydney
The University of Sydney
Finfer, Simon R.
Australia, Sydney
George Institute for Global Health
Australia, Sydney
The University of Sydney
Australia, Sydney
Royal North Shore Hospital
Bellomo, Rinaldo
Australia, Sydney
George Institute for Global Health
Australia, Melbourne
Austin Hospital
Billot, Laurent
Australia, Sydney
George Institute for Global Health
Cass, Alan
Australia, Sydney
George Institute for Global Health
Australia, Sydney
The University of Sydney
Gattas, David J.
Australia, Sydney
George Institute for Global Health
Australia, Sydney
The University of Sydney
Australia, Sydney
Royal Prince Alfred Hospital
Glass, Parisa
Australia, Sydney
George Institute for Global Health
Lipman, Jeffrey
Australia, Brisbane
Royal Brisbane and Women's Hospital
Liu, Bette C.
Australia, Sydney
George Institute for Global Health
Australia, Sydney
Unsw Sydney
McArthur, Colin J.
New Zealand, Auckland
Auckland City Hospital
McGuinness, Shay P.
New Zealand, Auckland
Auckland City Hospital
Rajbhandari, Dorrilyn
Australia, Sydney
Royal Prince Alfred Hospital
Taylor, Colman B.
Australia, Sydney
George Institute for Global Health
Australia, Sydney
The University of Sydney
Webb, Steve A.R.
Australia, Sydney
George Institute for Global Health
Australia, Perth
Royal Perth Hospital
Statistics
Citations: 1,316
Authors: 14
Affiliations: 10
Identifiers
Doi:
10.1056/NEJMoa1209759
ISSN:
00284793
Research Areas
Violence And Injury
Study Design
Randomised Control Trial