Fluid resuscitation after severe trauma injury
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Intensivmedizin und Notfallmedizin
Originalien Med Klin Intensivmed Notfmed https://doi.org/10.1007/s00063-019-00625-7 Received: 28 May 2019 Revised: 8 August 2019 Accepted: 25 August 2019 © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019 Redaktion M. Buerke, Siegen
E. Fleischhacker1 · H. Trentzsch2 · D. Kuppinger3 · S. Piltz1,7 · F. Beyer3,5 · F. Meigel3,4 · T. Kammerer6,8 · M. Rehm6 · W. H. Hartl3 1 Department of General, Trauma and Reconstruction Surgery with Integrated Fracture Liaison Service, University School of Medicine, Grosshadern Campus, Ludwig-Maximilian University, Munich, Germany; 2 Institut für Notfallmedizin und Medizinmanagement, Klinikum der Universität München, LudwigMaximilians Universität, Munich, Germany; 3 Department of General, Visceral and Transplantation Surgery, University School of Medicine, Grosshadern Campus, Ludwig-Maximilian University, Munich, Germany; 4 Department of Gynaecology, Municipal Hospital Traunstein, Traunstein, Germany; 5 Department of Orthopaedic Surgery, Municipal Hospital Schrobenhausen, Schrobenhausen, Germany; 6 Department of Anaesthesiology, University School of Medicine, Grosshadern Campus, LudwigMaximilian University, Munich, Germany; 7 Department of Orthopaedic Surgery, Municipal Hospital Coburg, Coburg, Germany; 8 Department of Anaesthesiology and Pain Therapy, Cardiac and Diabetes Centre North Rhine-Westphalia, Bochum, Germany
Fluid resuscitation after severe trauma injury U-shaped associations between tetrastarch dose and survival time or frequency of acute kidney failure
Electronic supplementary material The online version of this article (https://doi. org/10.1007/s00063-019-00625-7) includes a detailed discussion of studies evaluating tetrastarch (HES) dose (table S1), of general outcomes, and of limitations of individual studies/meta-analyses examining the effect of tetrastarch on morbidity and mortality in critically ill patients (tables S2, S3), graphs on the association between tetrastarch and the frequency of an acute kidney failure/the number of transfused packed red blood cell (PRBC) units (figures S1–S6), additional information on general care of trauma patients and details of the statistical analysis. Article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field; the supplementary material can be found under “Ergänzende Inhalte”.
Introduction Using hydroxyethyl starch (HES) for fluid resuscitation has been accused of increasing risks of death and acute kidney injury in critically ill patients. In June 2013, the European Medicines Agency’s (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) recommended that the marketing authorizations for HES be suspended. Since then, however, PRAC changed its recommendations twice recommending in October 2013 that HES should remain available for a short-term treatment of hypovolaemia (low blood volume) caused by acute (sudden) blood loss, where treatment with alternative infusions solutions (crystalloids) alone are not co
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