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ESICM: Death Equal for Colloid, Crystalloids in Hypovolemia

For patients in ICU with hypovolemic shock, 28-day mortality similar; 90-day death lower with colloids

WEDNESDAY, Oct. 9 (HealthDay News) -- For patients admitted to the intensive care unit (ICU) with hypovolemic shock, 28-day mortality is not significantly different with use of colloids versus crystalloids for fluid resuscitation, according to a study published online Oct. 9 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of the European Society of Intensive Care Medicine, held from Oct. 5 to 9 in Paris.

Djillali Annane, M.D., Ph.D., from the Raymond Poincaré Hospital in Garches, France, and colleagues conducted a multicenter randomized trial to examine whether use of colloids (1,414 patients) versus crystalloids (1,443 patients) for fluid resuscitation impacts mortality in patients admitted to the ICU with hypovolemic shock.

The researchers found that there were 359 deaths in the colloids group and 390 in the crystalloids group within 28 days (25.4 and 27.0 percent, respectively; relative risk, 0.96; P = 0.26). At 90 days, mortality was 30.7 and 34.2 percent, respectively (relative risk, 0.92; P = 0.03). There was no significant difference between the groups in the use of renal replacement therapy (P = 0.19).

"Among ICU patients with hypovolemia, the use of colloids versus crystalloids did not result in a significant difference in 28-day mortality," the authors write. "Although 90-day mortality was lower among patients receiving colloids, this finding should be considered exploratory."

Two authors disclosed financial ties to medical device and start-up companies.

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