Low molecular weight pentastarch is more effective than crystalloid solution in goal-directed fluid management in patients undergoing major gastrointestinal surgery

Kotake, Yoshifumi; Fukuda, Mitsue; Yamagata, Aya; Iwasaki, Ririko; Toyoda, Daisuke; Sato, Nobukazu; Ochiai, Ryoichi

doi:10.1007/s00540-013-1704-7

Cited by 14 publications

(14 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It appears that people undergoing major gastrointestinal surgery benefit most from HES over crystalloids. 131 Similar results have been shown in pigs undergoing major abdominal surgery. 132,133 Furthermore, HES show better restoration of splanchnic microcirculation than isotonic saline.…”

Section: Perioperative Fluid Challengesupporting

confidence: 73%

“…Differences between elective surgical and critically ill or septic patients include physiological–pharmacological (different aspects of Starling's equation, predisposition of AKI through primary disease state) and therapeutic (treatment duration and cumulative dose) parameters, and can explain their divergent outcomes. It appears that people undergoing major gastrointestinal surgery benefit most from HES over crystalloids . Similar results have been shown in pigs undergoing major abdominal surgery .…”

Section: Indications Considerations and Recommendations For The Usesupporting

confidence: 69%

See 1 more Smart Citation

Hydroxyethyl starches in equine medicine

Galen

Hallowell

2019

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objective To review and discuss the use of hydroxyethyl starches (HES) in equine veterinary medicine, and to provide recommendations for its use. Data sources Veterinary and human peer‐reviewed medical literature including scientific reviews, meta‐analyses, and original research articles. Human data synthesis Increasing evidences on adverse effects after HES use and decreasing support for beneficial effects with regards to volume expansion and colloid osmotic pressure (COP) support in critically ill subjects have led to a recent guideline to limit the use of HES in critically ill people. Equine veterinary data synthesis The rationale for HES use in horses is mainly extrapolated from human medicine, and very limited studies in horses are available. There is limited evidence suggesting a superiority of volume expansion effects of HES over crystalloids. The potential for HES to increase and maintain COP is well supported, but there is no evidence that maintaining or increasing plasma COP influences outcome, tissue edema formation, or rates of complications that potentially relate to edema formation. HES induce dose–dependent changes in coagulopathic parameters, but there is no evidence that HES causes clinical coagulopathies. Insufficient data are available on other adverse effects such as acute kidney injury, or mortality in horses. The use of HES should be restricted in septic patients, but may still have some use in cases of hemorrhagic shock resuscitation, hypoalbuminemia, or perioperative fluid replacement. Conclusion The evidence supporting the use of HES in horses is weak due to lack of species‐specific investigations. Acknowledging species differences, the use of HES should be judicious, yet with some recognition of its benefits in particular cases. More research is necessary to improve knowledge on use of HES in horses and to establish better future recommendations.

show abstract

Section: Perioperative Fluid Challengesupporting

confidence: 73%

Section: Indications Considerations and Recommendations For The Usesupporting

confidence: 69%

Hydroxyethyl starches in equine medicine

Galen

Hallowell

2019

J Vet Emergen Crit Care

View full text Add to dashboard Cite

show abstract

“…The use of colloids has been suggested to counteract this undesired volume overload, but studies evaluating the volume effects of HES in people have shown conflicting results. The administration of HES was found to improve hemodynamic parameters (ie, stroke volume index) in a group of patients undergoing gastrointestinal surgery necessitating a fluid challenge . Controversially, other studies evaluating stroke volume optimization in patients undergoing orthopedic surgery failed to demonstrate differences between HES and crystalloids in fluid challenge responses .…”

Section: Perioperative Fluid Therapymentioning

confidence: 98%

Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care

Adamik

Yozova

Stokar-Regenscheit

2015

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Currently, there are no consensus recommendations regarding the use of HES in veterinary medicine. Veterinarians and institutions affected by the HES restrictions have had to critically reassess the risks and benefits related to HES usage based on the available information and sometimes adapt their procedures and policies based on their reassessment. Meanwhile, large, prospective, randomized veterinary studies evaluating HES use are needed to achieve relevant levels of evidence to enable formulation of specific veterinary guidelines.

show abstract

“…Balanced and unbalanced solutions are compared Kotake et al 32 35 A colloid different from HE 6%: 130/0.4 is used L'Hermite et al 33 56 Does not include complications or mortality as primary result Dehne et al 34 60 A colloid different from HE 6%: 130/0.4 is used. GDFT is not performed Godet et al 35 65 GDFT is not performed Guo et al 36 42 A colloid different from HE 6%: 130/0.4 is used.…”

Section: Characteristics Of Studies Includedmentioning

confidence: 99%

Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions

Ripollés

Espinosa²,

Casans

et al. 2015

Brazilian Journal of Anesthesiology (English Edition)

View full text Add to dashboard Cite

Because of the limitations of this meta-analysis due to the small number of randomized clinical trials and patients included, the results should be taken cautiously, and the performance of new randomized clinical trials is proposed, with enough statistical power, comparing balanced and unbalanced colloids to balanced and unbalanced crystalloids, following the protocols of GDFT, considering current guidelines and suggestions made by groups of experts.

show abstract

Low molecular weight pentastarch is more effective than crystalloid solution in goal-directed fluid management in patients undergoing major gastrointestinal surgery

Abstract: HES 70/0.5 exerted larger volume effects than did crystalloid under nonspecific conditions. However, similar volume effects were observed during volume loss and extensive sympathetic blockade.

Cited by 14 publications

References 56 publications

Hydroxyethyl starches in equine medicine

Hydroxyethyl starches in equine medicine

Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care

Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions

Contact Info

Product

Resources

About