Synthetic Colloids Are Unsafe for Sepsis Resuscitation

Ninety-day mortality was significantly more common among patients who received hydroxyethyl starch than among those who received Ringer's acetate.

Early aggressive volume resuscitation lowers short-term mortality in patients with sepsis. Debate persists over whether resuscitation is best achieved with crystalloids or colloids. Recent studies have demonstrated higher risk for acute kidney injury with traditional synthetic colloids (e.g., Hespan), but limited data are available on using lower-molecular-weight formulations.

In this multicenter Scandinavian trial, 798 patients with severe sepsis were randomized to resuscitation with hydroxyethyl starch (HES) 130/0.4 or Ringer's acetate. HES 130/0.4 is a lower-molecular-weight product than Hespan, and Ringer's acetate is similar to lactated Ringer's (with acetate substituted for lactate, and with slightly higher sodium and chloride levels).…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar