Intensive Care Medicine

, Volume 36, Issue 10, pp 1724–1734 | Cite as

Do hypooncotic fluids for shock increase the risk of late-onset acute respiratory distress syndrome?

  • Frédérique Schortgen
  • Emmanuelle Girou
  • Nicolas Deye
  • Laurent Brochard
  • For the CRYCO Study Group



In patients with shock, late-onset acute respiratory distress syndrome (ARDS) carries poor prognosis. Hypooncotic fluids may improve kidney function preservation, whereas hyperoncotic fluids may in theory decrease the risk of late-onset ARDS. Our objective was to determine whether predominant or exclusive use of crystalloids and/or hypooncotic colloids for shock resuscitation influenced the risk of late-onset ARDS.

Participant and settings

International prospective cohort of consecutive adults who were free of ARDS on admission and who received fluid resuscitation for shock in 115 intensive care units (ICUs) during a 4-week period.

Measurements and results

Severity scores, hemodynamic status, indication for fluids, risk factors for ARDS, plasma expander use, transfusions, and late-onset ARDS were recorded prospectively. Logistic regression models were tested to determine whether predominant or exclusive use of hypooncotic fluids was associated with higher incidence of late-onset ARDS. Of 905 patients, 81 [8.9%; 95% confidence interval (CI) 7.2–11.0] developed ARDS, with no difference between patients given only hypooncotic fluids (10.4%; 95% CI 7.6–13.7) and the other patients (7.7%; 95% CI 5.5–10.5; p = 0.16). Late-onset ARDS was significantly associated with sepsis [odds ratio (OR) 1.90; 95% CI 1.06–3.40], worse chest X-ray score at fluid initiation (1.55; 95% CI 1.27–1.91), positive fluid balance (1.06 per l; 95% CI 1.02–1.09), and greater transfusion volume (1.14 per l; 95% CI 1.01–1.29). The proportion of hypooncotic fluids in the plasma expander regimen was not associated with late-onset ARDS (1.01 per %; 95% CI 0.99–1.01).


Based on this observational study, there is no evidence that in patients with shock the use of hypooncotic fluids increases the risk of late-onset ARDS. This finding needs to be confirmed.


ARDS Fluid resuscitation Colloids Crystalloids ICU Prognosis 



This study was supported by grant Projet Hospitalier de Recherche Clinique AOM00120 from the Assistance Publique-Hôpitaux de Paris (Paris Teaching Hospital Network, a nonprofit, publicly funded organization).

Supplementary material

134_2010_1905_MOESM1_ESM.doc (124 kb)
Supplementary material 1 (DOC 124 kb)


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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • Frédérique Schortgen
    • 1
    • 2
  • Emmanuelle Girou
    • 3
    • 4
  • Nicolas Deye
    • 5
  • Laurent Brochard
    • 1
    • 2
    • 4
  • For the CRYCO Study Group
  1. 1.Service de réanimation médicaleAP-HP, Groupe Hospitalier Albert Chenevier–Henri MondorCréteilFrance
  2. 2.Faculté de MédecineINSERM, U955CréteilFrance
  3. 3.Unité de Contrôle, Epidémiologie et Prévention de l’InfectionAP-HP, Groupe Hospitalier Albert Chenevier–Henri MondorCréteilFrance
  4. 4.Faculté de MédecineUniversité Paris 12CréteilFrance
  5. 5.Réanimation Médicale et ToxicologiqueAPHP, Hôpital Lariboisière-Fernand WidalParisFrance

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