Intensive Care Medicine

, Volume 35, Issue 9, pp 1539–1547

Effects of a predominantly hydroxyethyl starch (HES)-based and a predominantly non HES-based fluid therapy on renal function in surgical ICU patients

  • Franziska Schabinski
  • Janaina Oishi
  • Fabio Tuche
  • Alain Luy
  • Yasser Sakr
  • Donald Bredle
  • Christiane Hartog
  • Konrad Reinhart
Original

DOI: 10.1007/s00134-009-1509-1

Cite this article as:
Schabinski, F., Oishi, J., Tuche, F. et al. Intensive Care Med (2009) 35: 1539. doi:10.1007/s00134-009-1509-1

Abstract

Purpose

To compare the effects of predominantly hydroxyethyl starch (HES 6% 130/0.4)-based with predominantly gelatin 4%-based fluid therapy on renal function in surgical intensive care unit (ICU) patients.

Methods

Before–after, retrospective, study of surgical ICU patients. All patients admitted from January to June 2005 formed the HES group, with HES 130/0.4 as the standard colloid of choice. All patients admitted from January to June 2006 formed the GEL group, with gelatin 4% as the primary colloid. Acute renal failure (ARF) was defined as new need for renal replacement therapy (RRT) or at least a two-fold increase in baseline creatinine.

Results

There were 1383 patients in the HES group and 1528 in the GEL group; 118 and 87, in each group respectively, had severe sepsis. The incidence of ARF and ICU and hospital mortality rates were similar in the two groups. In a post-hoc multivariable analysis, cumulative doses >33 ml/kg of either HES (OR = 1.85, 95% CI: 1.01–3.41, p < 0.001) or gelatin (OR = 1.99, 95% CI: 1.05–3.79, p = 0.035) were associated with a higher risk of ARF.

Conclusions

The incidence of ARF was similar in patients who received predominantly HES (6% 130/.04) fluid therapy and in those who received predominantly gelatin 4%. Moderate cumulative doses of modern HES or gelatin solutions may be associated with a higher risk of ARF.

Keywords

Critical care Sepsis Hydroxyethyl starch Gelatin Renal failure 

Supplementary material

134_2009_1509_MOESM1_ESM.doc (352 kb)
Supplementary material 1 (DOC 352 kb)

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Franziska Schabinski
    • 1
  • Janaina Oishi
    • 1
  • Fabio Tuche
    • 1
  • Alain Luy
    • 1
  • Yasser Sakr
    • 1
  • Donald Bredle
    • 2
  • Christiane Hartog
    • 1
  • Konrad Reinhart
    • 1
  1. 1.Department of Anesthesiology and Intensive CareFriedrich-Schiller-University HospitalJenaGermany
  2. 2.Department of KinesiologyUniversity of WisconsinEau ClaireUSA

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