Effect of perioperative crystalloid or colloid fluid therapy on hemorrhage, coagulation competence, and outcome
| Autor: | Kirsten C. Rasmussen, Tom Pedersen, Niels H. Secher |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Fluid administration Crystalloid solutions Blood Loss Surgical Plasma Substitutes Postoperative Hemorrhage 030204 cardiovascular system & hematology Perioperative Care Hydroxyethyl Starch Derivatives fluid therapy 03 medical and health sciences 0302 clinical medicine Fluid therapy Blood loss 030202 anesthesiology Albumins Humans Medicine coagulation perioperative Elective surgery colloid business.industry Dextrans Crystalloid Solutions General Medicine Perioperative Thrombelastography Surgery crystalloid Anesthesia Meta-analysis Perioperative care ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Isotonic Solutions hemorrhage business Systematic Review and Meta-Analysis Research Article |
| Zdroj: | Medicine |
| ISSN: | 0025-7974 |
| DOI: | 10.1097/md.0000000000004498 |
| Popis: | Supplemental Digital Content is available in the text Background: A meta-analysis concerning perioperative coagulation competence, hemorrhage, and outcome was conducted including the use of hydroxyethyl starches (HESs), dextran, or albumin versus administration of a crystalloid as control to assess the efficacy and safety of colloids and crystalloids for fluid administration during major elective surgery. Surgery was restricted to cardiovascular and noncardiovascular surgery, and HESs were stratified to HES 130/0.4 and HES 200/0.5. Methods: We searched Cochrane Central Register of Controlled Trials, MEDLINE, ISI Web of Science, EMBASE, conference proceedings, reference lists, and databases of ongoing trials. Results: Thirty one primary clinical randomized controlled trials included 2287 patients undergoing major surgery from January 2000 to August 2015. The perioperative changes in coagulation competence were measured by thromboelastography (TEG) maximum amplitude (MA) in 9 studies administering crystalloids versus HES and in 4 studies administering albumin versus HES. All studies but 1 disclosed increased reduction in TEG-MA following HES administration (P = 0.0001 and 0.0002). The total loss of blood was reported in 17 studies in which crystalloids were compared to HES and 12 studies reported increased blood loss after administration of HES (P |
| Databáze: | OpenAIRE |
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