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Table 2 Meta-analyses and systematic reviews

From: Choices in fluid type and volume during resuscitation: impact on patient outcomes

Study Number of trials Number of patients Population Intervention Control Outcomes Conclusion
Serpa Neto 2014 10 4,624 Septic patients HES Crystalloids 28- and 90- day mortality, AKI, RRT, transfusion, LOS, fluid intake HES shows increase in AKI, RRT, need for RBC transfusion, and 90-day mortality
Zarychanski 2013 38 10,880 Critically ill, including sepsis, trauma, burn, hypovolemic shock HES Crystalloids, gelatin, albumin Mortality, AKI, LOS, MV After exclusion of Boldt studies, HES increased mortality, AKI, and RRT
Gattas 2013 35 10,391 Critically ill or surgical patients 6% HES 130/0.4-0.42 Other fluids Mortality, RRT, AKI, transfusion, bleeding Increased risk of RRT with HES
Hasse 2013 9 3,456 ICU patients with sepsis 6% HES 130/0.38-0.45 Crystalloids or albumin All cause mortality, RRT, AKI, bleeding and transfusion, adverse effects as defined in the individual studies HES increased RRT, increased blood transfusion, increased incidence of adverse effects
Gillies 2013 19 1,567 Surgical patients 6% HES Other colloids or crystalloids Postoperative in hospital mortality, AKI, RRT No difference in measured outcomes, no demonstrable benefit of HES
Perel 2013 70 22,392 Cochrane review 2013, critically ill Colloids Crystalloids Mortality Colloids do not decrease mortality, HES may increase mortality
Mutter 2013 42 11,399 Cochrane review HES Other fluids Renal function Increased need for RRT with all HES products in all patient populations
Bunn 2012 86 5,484 Critically ill and surgical patients in need of volume resuscitation, Cochrane review Any one colloid (included albumin, HES, dextran, gelatin) Any other colloid (included albumin, HES, dextran, gelatin) Mortality, need for blood transfusion, adverse events No benefit of one type of colloid over another
Thomas-Ruedel 2012 40 3,275 Adult and pediatric, primarily elective surgery, as well as ICU and ED Gelatin Albumin or crystalloid Mortality, blood products administration, AKI, RRT Unable to determine safety due to small studies and large heterogeneity
Rochwerg 2014 14 18,916 Adult patients with sepsis and septic shock Any fluid (colloid or crystalloid) Any fluid (colloid or crystalloid) Mortality, blood products administration, AKI, RRT Reduced mortality with balanced crystalloids and albumin compared to other fluids
  1. ICU, intensive care unit; HES, hydroxyethyl starch; AKI, acute kidney injury; RRT, renal replacement therapy; MV, mechanical ventilation; LOS, length of stay (ICU or hospital); ED, emergency department.