OBJECTIVE To assess shock reversal and required fluid volumes in patients with septic shock. DESIGN Prospective before and after study comparing three different treatment periods. SETTING Fifty-bed single-center surgical intensive care unit. PATIENTS Consecutive patients with severe sepsis. INTERVENTIONS Fluid therapy directed at preset hemodynamic goals with hydroxyethyl starch (predom...

Background: Haemodilution and hypothermia induce coagulopathy separately, but their combined effect on coagulation has not been widely studied. Fibrinogen concentrate can correct dilutional coagulopathy and has an additional effect when combined with factor XIII concentrate. However, their effect on dilutional coagulopathy concomitant with hypothermia has not been studied previously. Free oscil...

OBJECTIVES A previous meta-analysis has shown a consistent survival benefit in children with severe malaria receiving human albumin solution compared to other resuscitation fluids. Human albumin solution is expensive and not readily available in Africa. We examined the safety and efficacy of the fluid resuscitation with two synthetic colloids, Dextran 70 and hydroxyethyl starch, to inform futur...

BACKGROUND Haemodilution and hypothermia induce coagulopathy separately, but their combined effect on coagulation has not been widely studied. Fibrinogen concentrate can correct dilutional coagulopathy and has an additional effect when combined with factor XIII concentrate. However, their effect on dilutional coagulopathy concomitant with hypothermia has not been studied previously. Free oscill...

BACKGROUND The European Medicines Agency does not recommend the use of hydroxyethyl starch-based volume replacement solutions in critically ill patients due to an increased risk of renal failure. However, this recommendation is questionable for its perioperative use. Several recent randomised controlled studies do not indicate a risk for renal failure-not even after high-risk surgery. Human alb...

BACKGROUND The infusion of large amounts of Ringer's lactate prolongs the functional gastrointestinal recovery time and increases the number of complications after open abdominal surgery. We performed an open-labelled clinical trial to determine whether hydroxyethyl starch or Ringer's lactate exerts these adverse effects when the surgery is performed by laparoscopy. METHODS Eighty-eight patie...

1 Bellomo R, Bion J, Finfer S, Myburgh J, Perner A, Reinhart K. Open letter to the Executive Director of the European Medicine Agency concerning the licensing of hydroxyethyl starch solutions for fluid resuscitation. Br J Anaesth 2014; 112: 595–600 2 Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008; 358: 125–39 3...

OBJECTIVE To assess the effects of fluid therapy with hydroxyethyl starch 130/0.38-0.45 versus crystalloid or albumin on mortality, kidney injury, bleeding, and serious adverse events in patients with sepsis. DESIGN Systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. DATA SOURCES Cochrane Library, Medline, Embase, Biosis Previews, Science Citati...

Sodium carboxymethyl cellulose and hydroxyethyl starch were found to support rapid growth of two hematopoietic cell lines. The polymers were not metabolized by the cells. In the presence of these compounds, lower rates of glucose utilization and lactic acid production were observed. The uptake of glucose by the cells decreased as the concentration of the polymer in the medium was increased. The...

This-study evaluates the effects of the transfusion of frozen-thawed blood protected by hydroxyethyl starch (HES) on shocked monkeys. Particular attention is directed toward the study of coagulation in view of previous reports of coagulopathies caused by hydroxyethyl starch. In vivo studies were done in 13 shocked monkeys that received either homologous or autologous blood which had been frozen...