BACKGROUND For logistics, the US Army recommends Hextend (Hospira; 6% hetastarch in buffered electrolyte, HET) for battlefield resuscitation. To support this practice, there are laboratory data, but none in humans. To test the hypothesis that HET is safe and effective in trauma, we reviewed our first 6 months of use at a civilian level 1 trauma center. STUDY DESIGN From June 2008 to December ...

The crystalloid – colloid debate regarding the most effective intravenous fluid for resuscitation from haemorrhagic shock has been raging over the past 60 years, and still continues without a satisfactory resolution (1). Crystalloid solutions are essentially isotonic salt solutions (270-310 mOsm/L) and have been in use since the 1800s but their use became widespread during World War I. Normal s...

The crystalloid – colloid debate regarding the most effective intravenous fluid for resuscitation from haemorrhagic shock has been raging over the past 60 years, and still continues without a satisfactory resolution (1). Crystalloid solutions are essentially isotonic salt solutions (270-310 mOsm/L) and have been in use since the 1800s but their use became widespread during World War I. Normal s...

Forty-eight patients with fever greater than 38.3 degrees C for at least 24 hr despite broad spectrum antibiotics and an absolute granulocyte count less than 1000/microliter were randomly allocated to 4 days of granulocyte transfusions obtained by leukapheresis using filtration (n = 27) or gravity (n = 21) techniques, the latter permitting simultaneous nonmechanical collection of granulocytes a...

OBJECTIVE The image quality for gastrointestinal bleeding studies depends on the efficiency of red blood cell labeling. The in vitro technique has been used widely because of its high labeling efficiency. New data for the modified in vivo/in vitro method are lacking. This study reports on the high labeling efficiency that can be obtained with the modified in vivo/in vitro method and the pitfall...

PURPOSE To investigate the impacts of albumin synergized with hydroxyethyl starch (HES) on early microvascular albumin leakage after major abdominal surgery in rabbits. METHODS Forty male Japanese rabbits were randomly divided into four groups: the control group, the saline group, the albumin group, and the Syn group (hydroxyethyl starch+albumin). The latter three groups were performed gastre...

OBJECTIVE To determine whether the perioperative use of hydroxyethyl starch 6% and albumin 5% in elective joint arthroplasties are associated with an increased risk for perioperative complications. DESIGN Retrospective cohort study of population based data between 2006 and 2013. SETTING Data from 510 different hospitals across the United States participating in the Premier Perspective datab...

The present Clinical practice guide responds to the clinical questions about security in the choice of fluid (crystalloid, colloid or hydroxyethyl starch 130) in patients who require volume replacement during perioperative period of non-cardiac surgeries. From the evidence summary, recommendations were made following the GRADE methodology. In this population fluid therapy based on crystalloids ...

Proper fluid management is crucial for the management of critically ill patients. However, there is a continuing debate about the choice of the fluid, i.e., crystalloid vs. colloid. Colloid solution is theoretically advantageous to the crystalloid because of larger volume effect and less interstitial fluid accumulation, and hydroxyethyl starch (HES) is most frequently used for perioperative set...