Effect of hydroxyethyl starch vs saline for volume replacement therapy on death or postoperative complications among high-risk patients undergoing major abdominal surgery: the FLASH randomized clinical trial.
There are few drugs that have gone through such a rollercoaster ride as hydroxyethyl starch (HES). While shortly after its introduction the belief still prevailed that all types of volume […]
Restrictive versus liberal fluid therapy for major abdominal surgery.
This article has the potential to influence or even to change current clinical fluid therapy during surgery, as it questions the often advocated practice of restrictive fluid administration. Although the […]
2017 EACTS/EACTA Guidelines on patient blood management for adult cardiac surgery.
There is growing evidence that patient blood management (PBM) is becoming “standard of care” in major surgery associated with high blood loss, particularly in cardiac surgery. These guidelines are the […]
Effect of an early resuscitation protocol on in-hospital mortality among adults with sepsis and hypotension: a randomized clinical trial.
This single-centre, randomised, controlled, non-blinded study evaluated the potential beneficial effect of an early goal-directed therapy (EGDT) protocol on sepsis outcomes among 212 patients in Zambia. The sepsis protocol was a […]
Hydroxyethyl starch 130/0.4 and the risk of acute kidney injury after cardiopulmonary bypass: a single-center retrospective study.
This single-centre retrospective study reports a greater incidence of acute kidney injury (AKI) in the immediate postoperative period when balanced HES 130/0.4 versus a balanced crystalloid solution was used for […]
Intravascular volume therapy in adults: Guidelines from the Association of the Scientific Medical Societies in Germany.
These guidelines on volume therapy should be considered in the bundle concept of patient blood management (PBM) for enhancing tolerance to anaemia and for correction of absolute hypovolaemia due to […]
Meta-analysis of colloids versus crystalloids in critically ill, trauma and surgical patients.
This new meta-analysis comparing colloids to crystalloids in critically ill, trauma and surgical patients confirms what we already know on the topic: 1. In the population studied, colloids did not […]
Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the intensive care unit: the SPLIT randomized clinical trial.
The SPLIT study, a double-bind, cluster randomised, double-crossover trial that was conducted in 4 ICUs and enrolled 2278 patients, aimed to answer a very practical question: what is the relationship between infusion […]
Albumin administration is associated with acute kidney injury in cardiac surgery: a propensity score analysis.
In this retrospective study including 984 patients undergoing cardiac surgery, the authors observed that perioperative albumin administration was associated with an increased risk of acute kidney injury. This effect was proportional […]
Goal-directed resuscitation for patients with early septic shock.
The Australasian Resuscitation in Sepsis Evaluation (ARISE) was a multicentre randomised study comparing early goal-directed therapy (EGDT) according to the protocol proposed by Rivers et al. (N Engl J Med […]
6% Hydroxyethyl starch (130/0.4) vs Ringer’s lactate preloading before spinal anaesthesia for Caesarean delivery: the randomized, double-blind, multicentre CAESAR trial.
This French multicentre study compared the effect of HES / Ringer Lactate (RL) combination (500 mL each) versus RL alone (1000 mL) on the hypotension induced by spinal anaesthesia with phenylephrine prophylaxis […]
Effects of a multimodality blood conservation schema toward improvement of intraoperative hemoglobin levels and off-pump transfusions in coronary artery bypass graft surgery.
This observational, retrospective before-and-after single-centre study reports that the reduction of intraoperative haemodilution obtained through a decrease in the amount of fluid administered before and during the cardiopulmonary bypass may […]
Effects of liposome-encapsulated hemoglobin on gastric wound healing in the rat.
This article confirms previous findings that using high-affinity haemoglobin oxygen carriers including modified RBCs, haemoglobin vesicles and PEG-conjugated haemoglobin provides improved oxygenation of ischaemic tissue relative to using low-flow-affinity carriers. […]
Biological evaluation of liposome-encapsulated hemoglobin surface-modified with a novel PEGylated nonphospholipid amphiphile.
Liposome encapsulation of haemoglobin (LEH) holds promise as a way to deliver high concentration of haemoglobin and perhaps provide sufficient oxygen carrying-capacity in conditions of significant blood loss. Many experimental […]
Influence of goal-directed therapy with balanced crystalloid-colloid or unbalanced crystalloid solution on base excess.
The authors showed similar fluid requirements with 3% tetrastarch (in balanced solvent) and unbalanced crystalloid in 40 patients undergoing a standardised surgical procedure, primary hip replacement, with only moderate bleeding. […]