resuscitation with low volume hydroxyethylstarch 130 kda0.4 is not associated with acute kidney injury复苏与低成交量hydroxyethylstarch 130 kda0.4不是与急性肾损伤有关.pdfVIP

Boussekey et al. Critical Care 2010, 14:R40 /content/14/2/R40 RESEARCH Open Access Resuscitation with low volume hydroxyethylstarch 130 kDa/0.4 is not associated with acute kidney injury 1* 1 1 1 2 1 Nicolas Boussekey , Raphaël Darmon , Joachim Langlois , Serge Alfandari , Patrick Devos , Agnes Meybeck , Arnaud Chiche1 1 1 , Hugues Georges , Olivier Leroy Abstract Introduction: Acute kidney injury (AKI) in the ICU is associated with poorer prognosis. Hydroxyethylstarch (HES) solutions are fluid resuscitation colloids frequently used in the ICU with controversial nephrotoxic adverse effects. Our study objective was to evaluate HES impact on renal function and organ failures. Methods: This observational retrospective study included 363 patients hospitalized for more than 72 hours in our ICU. A hundred and sixty eight patients received HES during their stay and 195 did not. We recorded patients’ baseline characteristics on admission and type and volume of fluid resuscitation during the first 3 weeks of ICU stay. We also noted the evolution of urine output, the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function and end-stage kidney disease (RIFLE) classification and sepsis related organ failure assessment (SOFA) score over 3 weeks. Results: Patients in the HES group were more severely ill on admission but AKI incidence was similar, as well as ICU mortality. The evolution of urine output (P = 0.74), RIFLE classification (P = 0.44) and SOFA score (P = 0.23) was not different. However, HES volumes administered were low (763+/-593 ml during the first 48 hours). Conclusions: Volume