Long-term outcomes in patients with severe sepsis randomised to resuscitation with hydroxyethyl starch 130/0.42 or Ringer's acetate.
Purpose: We assessed long-term mortality and hospitalisation in patients with severe sepsis resuscitated with hydroxyethyl starch (HES) or Ringer's acetate.Methods: This was an investigator-initiated, parallel-grouped, blinded randomised trial using computer-generated allocation sequence and central...
| Publicado en: | Intensive Care Medicine Vol. 40; no. 7; pp. 927 - 935 |
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| Autores principales: | , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Springer Nature
Jul2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103829481&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103829481 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03424642 4BC jtl: Intensive Care Medicine issn: 03424642 maglogo: N pubinfo: dt: Jul2014 vid: 40 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 103829481 NLM24807084 2012621631 10.1007/s00134-014-3311-y NLM24807084 103829481 ppf: 927 ppct: 8 formats: tig: atl: Long-term outcomes in patients with severe sepsis randomised to resuscitation with hydroxyethyl starch 130/0.42 or Ringer's acetate. aug: au: Perner, Anders Haase, Nicolai Winkel, Per Guttormsen, Anne B Tenhunen, Jyrki Klemenzson, Gudmundur Müller, Rasmus G Aneman, Anders Wetterslev, Jørn affil: Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, 2100, Copenhagen, Denmark, anders.perner@regionh.dk. sug: subj: Fluid Therapy Methods Hydroxyethyl Starch Therapeutic Use Isotonic Solutions Therapeutic Use Sepsis Mortality Sepsis Therapy Aged Double-Blind Studies Female Prospective Studies Hospitalization Human Intensive Care Units Male Middle Age Readmission Statistics and Numerical Data Resuscitation Methods Scandinavia Severity of Illness Indices Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Purpose: We assessed long-term mortality and hospitalisation in patients with severe sepsis resuscitated with hydroxyethyl starch (HES) or Ringer's acetate.Methods: This was an investigator-initiated, parallel-grouped, blinded randomised trial using computer-generated allocation sequence and centralised allocation data that included 804 patients with severe sepsis needing fluid resuscitation in 26 general intensive care units (ICUs) in Scandinavia. Patients were allocated to fluid resuscitation using either 6% HES 130/0.42 or Ringer's acetate during ICU admission. We assessed mortality rates at 6 months, 1 year and at the time of longest follow-up and days alive and out of hospital at 1 year.Results: The vital status of all patients was obtained at a median of 22 (range 13-36) months after randomisation. Mortality rates in the HES versus Ringer's groups at 6 months were 53.3 (212/398 patients) versus 47.5% (190/400) [relative risk 1.12; 95% confidence interval (CI) 0.98-1.29; P = 0.10], respectively; at 1 year, 56.0 (223/398) versus 51.5% (206/400) (1.09; 95% CI 0.96-1.24; P = 0.20), respectively; at the time of longest follow-up, 59.8 (238/398) versus 56.3% (225/400) (1.06; 95% CI 0.94-1.20; P = 0.31), respectively. Percentage of days alive and out of hospital at 1 year in the HES versus Ringer's groups was 24 (0-87 days) versus 63% (0-90) (P = 0.07).Conclusions: The long-term mortality rates did not differ in patients with severe sepsis assigned to HES 130/0.42 versus Ringer's acetate, but we could not reject a 24% relative increased or a 4% relative decreased mortality at 1 year with HES at the 95% confidence level. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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