Document Detail


Consensus statement of the ESICM task force on colloid volume therapy in critically ill patients.
MedLine Citation:
PMID:  22323076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Colloids are administered to more patients than crystalloids, although recent evidence suggests that colloids may possibly be harmful in some patients. The European Society of Intensive Care Medicine therefore assembled a task force to compile consensus recommendations based on the current best evidence for the safety and efficacy of the currently most frequently used colloids--hydroxyethyl starches (HES), gelatins and human albumin.
METHODS: Meta-analyses, systematic reviews and clinical studies of colloid use were evaluated for the treatment of volume depletion in mixed intensive care unit (ICU), cardiac surgery, head injury, sepsis and organ donor patients. Clinical endpoints included mortality, kidney function and bleeding. The relevance of concentration and dosage was also assessed. Publications from 1960 until May 2011 were included. The quality of available evidence and strength of recommendations were based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RECOMMENDATIONS AND CONCLUSIONS: We recommend not to use HES with molecular weight ≥ 200 kDa and/or degree of substitution >0.4 in patients with severe sepsis or risk of acute kidney injury and suggest not to use 6% HES 130/0.4 or gelatin in these populations. We recommend not to use colloids in patients with head injury and not to administer gelatins and HES in organ donors. We suggest not to use hyperoncotic solutions for fluid resuscitation. We conclude and recommend that any new colloid should be introduced into clinical practice only after its patient-important safety parameters are established.
Authors:
Konrad Reinhart; Anders Perner; Charles L Sprung; Roman Jaeschke; Frederique Schortgen; A B Johan Groeneveld; Richard Beale; Christiane S Hartog;
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Publication Detail:
Type:  Consensus Development Conference; Journal Article     Date:  2012-02-10
Journal Detail:
Title:  Intensive care medicine     Volume:  38     ISSN:  1432-1238     ISO Abbreviation:  Intensive Care Med     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-27     Completed Date:  2012-06-21     Revised Date:  2014-11-13    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-83     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic
Colloids / adverse effects,  contraindications,  therapeutic use*
Critical Illness / therapy*
Evidence-Based Medicine*
Fluid Therapy / methods,  standards*
Humans
Meta-Analysis as Topic
Review Literature as Topic
Risk Assessment
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Colloids
Comments/Corrections
Comment In:
Intensive Care Med. 2012 Sep;38(9):1561-2   [PMID:  22814864 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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