NDLI: Safety of modern starches used during surgery.

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Safety of modern starches used during surgery.

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Safety of modern starches used during surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Van Der Linden, Philippe James, Michael Mythen, Michael Weiskopf, Richard B.
Description	Country affiliation: Belgium Author Affiliation: Van Der Linden P ( Service D'AnésthesiologieRéanimation, CHU Brugmann, Bruxelles, Belgium.)
Abstract	Various hydroxyethyl starch (HES) preparations have been used for decades to augment blood volume. There has been concern recently regarding possible adverse outcomes when using HES in the intensive care setting, especially in patients with septic shock. However, the pharmacokinetic and pharmacodynamic properties of HES preparations depend on their chemical composition and source material. Thus, different clinical conditions could result in differing effectiveness and safety for these preparations. Consequently, we assessed the safety of tetrastarches when used during surgery, using a formal search, that yielded 59 primary full publications of studies that met a priori inclusion criteria and randomly allocated 4529 patients with 2139 patients treated with tetrastarch compared with 2390 patients treated with a comparator. There were no indications that the use of tetrastarches during surgery induces adverse renal effects as assessed by change or absolute concentrations of serum creatinine or need for renal replacement therapy (39 trials, 3389 patients), increased blood loss (38 trials, 3280 patients), allogeneic erythrocyte transfusion (20 trials, 2151 patients; odds ratio for HES transfusion 0.73 [95% confidence interval = 0.61-0.87], P = 0.0005), or increased mortality (odds ratio for HES mortality = 0.51 [0.24-1.05], P = 0.079).
File Format	HTM / HTML
ISSN	00032999
Issue Number	1
Volume Number	116
e-ISSN	15267598
Journal	Anesthesia & Analgesia
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2013-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Hydroxyethyl Starch Derivatives Adverse Effects Plasma Substitutes Surgical Procedures, Operative Methods Blood Coagulation Blood Loss, Surgical Blood Transfusion Statistics & Numerical Data Confidence Intervals Erythrocyte Transfusion Humans Therapeutic Use Intraoperative Care Odds Ratio Prospective Studies Randomized Controlled Trials As Topic Safety Mortality Journal Article Meta-analysis Research Support, Non-u.s. Gov't Review
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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