Effects of resuscitation with human albumin 5%, hydroxyethyl starch 130/0.4 6%, or crystalloid on kidney damage in an ovine model of septic shock

Kampmeier, Tim; Arnemann, Philip; Heßler, Michael; Bockbreder, K.; Wald, Abigail I.; Morelli, Andrea; Rehberg, Sebastian; Ertmer, Christian

doi:10.1016/j.bja.2018.04.041

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…The 14 included studies comprised 8 RCTs in patients, 6,9,10,18–22 1 observational study reporting unadjusted estimates in patients 23 and 5 randomised animal trials 24–28 …”

Section: Resultsmentioning

confidence: 99%

“…Two out of eight RCTs were judged to have an overall low risk of bias 6,9 and six were judged to have an overall high risk of bias 10,18–22 . All of the randomised animal trials were judged to have an overall high risk of bias 24–28 10,26,27 incomplete soutcome data 21,28 and lack of blinding 18 (Tables 2 and 3; Figure and S5).…”

Section: Resultsmentioning

confidence: 99%

“…All of the randomised animal trials were judged to have an overall high risk of bias 24–28 10,26,27 incomplete soutcome data 21,28 and lack of blinding 18 (Tables 2 and 3; Figure and S5).…”

Section: Resultsmentioning

confidence: 99%

“…The meta‐analysis of the five randomised animal trials (overall high risk of bias) 24–28 including 92 test animals showed no statistically significant difference in mortality between animals treated with hydroxyethyl starch 130/0.38–0.45 compared with crystalloid (RR 0.92, 95% CI 0.45 to 1.85; p = .81; I 2 = 0%; Figure 2). The quality of evidence was judged to be low (downgraded for risk of bias and imprecision), Table 5.…”

Section: Resultsmentioning

confidence: 99%

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Use of hydroxyethyl starch in sepsis research: A systematic review with meta‐analysis

Johansen

Perner

Brodtkorb

et al. 2021

Acta Anaesthesiol Scand

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Background After being used for more than a decade the use of hydroxyethyl starch (HES) 130/0.38–0.45 in clinical practice was discouraged because of serious adverse events including bleeding, acute kidney injury and death. But could these adverse effects have been discovered sooner? By comparing the summary effect estimates of the adverse effects of HES 130/0.38–0.45 in different study designs we aimed to disclose any signal of this. Methods We systematically searched MEDLINE, EMBASE and Cochrane Library and hand‐searched the reference lists of relevant studies to identify studies for inclusion. Eligible trials were randomised clinical trials (RCTs) and observational studies in patients with sepsis and randomised trials in animals with induced sepsis comparing HES 130/0.38–0.45 to any type of crystalloid. Relevant outcomes were all‐cause mortality at longest follow‐up, renal replacement therapy (RRT), acute kidney injury (AKI) and bleeding. We extracted data, conducted conventional meta‐analyses and assessed the risk of bias and the quality of evidence. Results We included 8 RCTs including 3,273 patients, 1 observational study including 379 patients and 5 randomised animal trials including 94 test animals. There was no suggestion of interaction in subgroup analyses comparing the different study designs for any outcomes (all‐cause mortality at longest follow‐up p = .33; RRT p = .70; AKI p = .63; bleeding p = .20). Conclusions We observed no interaction between the summary effect estimates of RCTs, observational studies in patients and randomised animal trials for any of the outcomes. Accordingly, we found no evidence indicating that the adverse effects of HES 130/0.38–0.45 could have been discovered sooner. Systematic review registration PROSPERO ID: CRD42018103422. Protocol Johansen JR, Perner A, Brodtkorb JH, Møller MH. Use of hydroxyethyl starch in sepsis research: Protocol for a systematic review. Acta Anaesthesiol Scand. 2019;63:814–818. https://doi.org/10.1111/aas.13345

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“…The 14 included studies comprised 8 RCTs in patients, 6,9,10,18–22 1 observational study reporting unadjusted estimates in patients 23 and 5 randomised animal trials 24–28 …”

Section: Resultsmentioning

confidence: 99%