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RETRACTED ARTICLE: The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: a review

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This article was retracted on 13 May 2020

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Abstract

Purpose

An optimal volume replacement strategy aims to restore systemic hemodynamics with the ultimate goals of improving organ perfusion and microcirculation for sustaining adequate tissue oxygenation. This review presents the (patho)physiological basis of hypovolemia, microcirculation, and tissue oxygenation and presents a literature review on the effects of plasma substitutes on microperfusion and oxygenation in the clinical setting.

Methods

Literature review of the effects of fluid therapy on microcirculation and tissue oxygenation using PubMed search including original papers in English from 1988 to 2009.

Results

We identified a total of 14 articles dealing with the effects of different crystalloids and colloids on organ perfusion, microcirculation, and tissue oxygenation in patients. The results are divergent, but there is a general trend that colloids are superior to crystalloids in improving organ perfusion, microcirculation, and tissue oxygenation. Due to the limited number of studies and different study conditions, a meta-analysis on the effects of the volume replacement strategies on microcirculation is not possible.

Conclusions

Improving the microcirculation by volume replacement appears to be a promising issue when treating the critically ill. The growing insights from animal experiments have to be translated into the clinical setting to identify the optimal fluid regimen for correcting hypovolemia. New techniques for monitoring microcirculation at the bedside might provide such endpoints, although these have to be validated also in the clinical setting. Whether improved microperfusion and tissue oxygenation by fluid therapy will also improve patient outcomes will have to be proven by future studies.

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Change history

  • 13 May 2020

    The Editor-in-Chief has retracted this article [1] because a number of studies included in this review [2, 3, 4] (originally cited as references 24, 49, 51) have subsequently been retracted. This has rendered the content of the review unreliable.

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Acknowledgments

The authors gratefully acknowledge the talents of Darryl Milstein who produced Figs. 1 and 2 in this paper. This study was supported only by an institutional grant.

Conflict of interest statement

Boldt and his institution have received funding from B. Braun (Germany); Fresenius-Kabi (Germany); Serumwerke Bernburg (Germany); Baxter (Europe). Ince holds a patent on SDF imaging, has stock in Microvision Medical, and has received educational grants from Hutchinison Technology, Baxter, Novartis, and Eli Lilly.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen, Germany

    Joachim Boldt

  2. Department of Intensive Care, Erasmus MC University Hospital Rotterdam, Rotterdam, The Netherlands

    Can Ince

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  1. Joachim Boldt
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  2. Can Ince
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Corresponding author

Correspondence to Joachim Boldt.

Additional information

The Editor-in-Chief has retracted this article [1] because a number of studies included in this review [2, 3, 4] (originally cited as references 24, 49, 51) have subsequently been retracted. This has rendered the content of the review as unreliable.

Author Joachim Boldt has not responded to any correspondence from the publisher about this retraction. Author Can Ince agrees to the retraction.

[1] Boldt, J., Ince, C. The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: a review. Intensive Care Med 36, 1299–1308 (2010). https://doi.org/10.1007/s00134-010-1912-7

[2] Boldt J, Suttner S, Brosch C, Lehmann A, Röhm K, Mengistu A (2009) The influence of a balanced volume replacement concept on inflammation, endothelial activation, and kidney integrity in elderly cardiac surgery patients. Intensive Care Med 35:462–470

[3] Lang K, Boldt J, Suttner S, Haisch G (2001) Colloids versus crystalloids and tissue oxygen tension in patients undergoing major abdominal surgery. Anesth Analg 93:405–409

[4] Boldt J, Heesen M, Muller M, Pabsdorf M, Hempelmann G (1996) The effects of albumin versus hydroxyethyl starch solution on cardiorespiratory and circulatory variables in critically ill patients. Anesth Analg 83:254–261

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Boldt, J., Ince, C. RETRACTED ARTICLE: The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: a review. Intensive Care Med 36, 1299–1308 (2010). https://doi.org/10.1007/s00134-010-1912-7

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