Essential reading material. The largest PRCT of Albumin vs Saline in 7,000 critically ill patients in Australia and New Zealand. Concludes “no-difference” in 28 day mortality. Subset trends to excess mortality with Albumin in trauma and head injury (more intra-cerebral bleeds) and reduced mortality with Albumin in sepsis. For those of us that never use […]
Use of perflubron emulsion to decrease allogeneic blood transfusion in high-blood-loss non-cardiac surgery: results of a European phase 3 study.
The authors should be commended for carrying out an elaborate multicenter study in such an elegant fashion. The Methods are well described, the statistics appropriate and the Results are presented according to the highest standards for a randomized controlled trial (intent-to-treat, post-hoc analyses, etc.). The study highlights the following points: augmented ANH will only be […]
Intravascular volume replacement therapy with synthetic colloids: is there an influence on renal function?
A good summary of the literature on this frequently asked question. Some excellent tables and a useful citation listing. The important take home message is sadly all too familiar: inadequate studies to allow an evidence based reccommendation, bigger studies needed, etc.! In otherwords, no ‘evidence based’ reason need to change your current practice, whatever it […]
The influence of crystalloid and colloid replacement solutions in acute normovolemic hemodilution: a preliminary survey of hemostatic markers.
This prospective randomized single blinded study nicely showed the dual effects of plasma substitutes used in acute normovolemic hemodilution. Solutions that have an impact on hemostasis like dextran and high molecular weight starches may attenuate the hypercoagulability phase usually observed in the immediate postoperative period, but their use can be associated with increased perioperative bleeding. […]
Intraoperative colloid administration reduces postoperative nausea and vomiting and improves postoperative outcomes compared with crystalloid administration.
An important and long awaited addition to the colloid vs crystalloid debate. A blinded, adequately powered PRCT that asks a sensible, hypothesis driven question, i.e., Is there a difference in edema related postoperative complications when colloids are compared to crystalloids? Essential reading for anyone planning a study in this area. Perhaps uneasy reading for the […]