0.9 % Saline vs 6 % HES 130/0.4 for fluid resuscitation in critically ill patients

Excerpt

The administration of colloids, and hydroxyehtyl starch (HES) in particular, in critically ill patients has been questioned by several studies, with different conclusions regarding outcomes and kidney injury. Older HES solutions have been shown to correlate significantly with acute kidney injury [1], but the question remains open for newer, lower molecular weight and lower MS preparations (tetrastarches). Recently, a Scandinavian trial has reported that 6 % HES 130/0.42 significantly increased mortality in patients with severe sepsis and septic shock [2]. To further assess safety and efficacy of HES solutions, the CHEST investigators have conducted a large-scale trial comparing 6 % HES 130/0.40 (Voluven) to normal saline in ICU patients. …