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 |