Controversies in fluid therapy: Type, dose and toxicity

Table 4 Summary of randomized trials of hydroxyethyl starch resuscitation in severe sepsis/septic shock and kidney outcomes

Ref.	RCT type	n(HES/CON)	Population (n)	HES fluid	Control fluid	Kidney parameters	RRT (OR; 95%CI)
Schortgen et al[50]	Multi-centre	129 (65/64)	Severe sepsis/ septic shock	6% (200/0.62)	3% gelatin	↑ AKI ↑ oliguria, ↑ peak SCr	1.20 (0.5-2.9)
Molnár et al[69]	Single centre	30 (15/15)	Septic shock	6% (200/0.60)	3% gelatin	NR	NR
McIntyre et al[70]	Multi-centre	40 (21/19)	Septic shock	6% (200/0.50)	0.9% NS	No difference	3.00 (0.3-31.6)
Brunkhorst et al[42]	Multi-centre	537 (262/275)	Severe sepsis/septic shock	10% (200/0.5)	RL	↑ AKI	1.95 (1.3-2.9)
Guidet et al[23]	Multi-centre	196 (100/96)	Severe sepsis/septic shock	6% (130/0.4)	0.9% NS	No difference	NR
Perner et al[6]	Multi-centre	798 (398/400)	Severe sepsis/septic shock	6% (130/0.42)	Ringer’s acetate	↑ AKI	1.35 (1.01-1.8)
Myburgh et al[5]	Multi-centre	7000 (3315/3336)	Sepsis (27.4%) (1921/7000)	6% (130/0.4)	0.9% NS	↑ RRT	1.21 (1.00-1.45)

RCT: Randomized clinical trial; HES: Hydroxyethyl starch; CON: Control; NS: Normal saline; RL: Ringer’s lactate; AKI: Acute kidney injury; RRT: Renal replacement therapy; NR: Not report.