Effects of hydroxyethyl starch administration on renal function in critically ill patients
Identifieur interne : 001762 ( Istex/Corpus ); précédent : 001761; suivant : 001763Effects of hydroxyethyl starch administration on renal function in critically ill patients
Auteurs : Y. Sakr ; D. Payen ; K. Reinhart ; F. S. Sipmann ; E. Zavala ; J. Bewley ; G. Marx ; J.-L. VincentSource :
- British Journal of Anaesthesia [ 0007-0912 ] ; 2007-02.
Abstract
Background The influence of hydroxyethyl starch (HES) solutions on renal function is controversial. We investigated the effect of HES administration on renal function in critically ill patients enrolled in a large multicentre observational European study. Methods All adult patients admitted to the 198 participating intensive care units (ICUs) during a 15-day period were enrolled. Prospectively collected data included daily fluid administration, urine output, sequential organ failure assessment (SOFA) score, serum creatinine levels, and the need for renal replacement therapy (RRT) during the ICU stay. Results Of 3147 patients, 1075 (34) received HES. Patients who received HES were older [mean (sd): 62 (sd17) vs 60 (18) years, P 0.022], more likely to be surgical admissions, had a higher incidence of haematological malignancy and heart failure, higher SAPS II [40.0 (17.0) vs 34.7 (16.9), P < 0.001] and SOFA [6.2 (3.7) vs 5.0 (3.9), P < 0.001] scores, and less likely to be receiving RRT (2 vs 4, P < 0.001) than those who did not receive HES. The renal SOFA score increased significantly over the ICU stay independent of the type of fluid administered. Although more patients who received HES needed RRT than non-HES patients (11 vs 9, P 0.006), HES administration was not associated with an increased risk for subsequent RRT in a multivariable analysis [odds ratio (OR): 0.417, 95 confidence interval (CI): 0.053.27, P 0.406]. Sepsis (OR: 2.03, 95 CI: 1.373.02, P < 0.001), cardiovascular failure (OR: 6.88, 95 CI: 4.4910.56, P < 0.001), haematological cancer (OR: 2.83, 95 CI: 1.286.25, P 0.01), and baseline renal SOFA scores > 1 (P < 0.01 for renal SOFA 2, 3, and 4 with renal SOFA 0 as a reference) were all associated with a higher need for RRT. Conclusions In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU. The administration of HES had no influence on renal function or the need for RRT in the ICU.
Url:
DOI: 10.1093/bja/ael333
Links to Exploration step
ISTEX:D68F9DBDE53F44F60A256C642806F7757808A113Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Effects of hydroxyethyl starch administration on renal function in critically ill patients</title><author><name sortKey="Sakr, Y" sort="Sakr, Y" uniqKey="Sakr Y" first="Y." last="Sakr">Y. Sakr</name><affiliation><mods:affiliation>Friedrich-Schiller-University, Jena, Germany</mods:affiliation></affiliation></author><author><name sortKey="Payen, D" sort="Payen, D" uniqKey="Payen D" first="D." last="Payen">D. Payen</name><affiliation><mods:affiliation>Centre Hospitalier Universitaire Lariboisiere, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Reinhart, K" sort="Reinhart, K" uniqKey="Reinhart K" first="K." last="Reinhart">K. Reinhart</name><affiliation><mods:affiliation>Friedrich-Schiller-University, Jena, Germany</mods:affiliation></affiliation></author><author><name sortKey="Sipmann, F S" sort="Sipmann, F S" uniqKey="Sipmann F" first="F. S." last="Sipmann">F. S. Sipmann</name><affiliation><mods:affiliation>Fundacin Jimnez Daz, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Zavala, E" sort="Zavala, E" uniqKey="Zavala E" first="E." last="Zavala">E. Zavala</name><affiliation><mods:affiliation>Hospital Clinic of Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Bewley, J" sort="Bewley, J" uniqKey="Bewley J" first="J." last="Bewley">J. Bewley</name><affiliation><mods:affiliation>Bristol Royal Infirmary, Bristol, UK</mods:affiliation></affiliation></author><author><name sortKey="Marx, G" sort="Marx, G" uniqKey="Marx G" first="G." last="Marx">G. Marx</name><affiliation><mods:affiliation>Friedrich-Schiller-University, Jena, Germany</mods:affiliation></affiliation></author><author><name sortKey="Vincent, J L" sort="Vincent, J L" uniqKey="Vincent J" first="J.-L." last="Vincent">J.-L. Vincent</name><affiliation><mods:affiliation>Erasme Hospital, Free University of Brussels, Belgium on behalf of the Sepsis Occurrence in Acutely Ill Patients investigators</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jlvincen@ulb.ac.be</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:D68F9DBDE53F44F60A256C642806F7757808A113</idno><date when="2007" year="2007">2007</date><idno type="doi">10.1093/bja/ael333</idno><idno type="url">https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001762</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Effects of hydroxyethyl starch administration on renal function in critically ill patients</title><author><name sortKey="Sakr, Y" sort="Sakr, Y" uniqKey="Sakr Y" first="Y." last="Sakr">Y. Sakr</name><affiliation><mods:affiliation>Friedrich-Schiller-University, Jena, Germany</mods:affiliation></affiliation></author><author><name sortKey="Payen, D" sort="Payen, D" uniqKey="Payen D" first="D." last="Payen">D. Payen</name><affiliation><mods:affiliation>Centre Hospitalier Universitaire Lariboisiere, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Reinhart, K" sort="Reinhart, K" uniqKey="Reinhart K" first="K." last="Reinhart">K. Reinhart</name><affiliation><mods:affiliation>Friedrich-Schiller-University, Jena, Germany</mods:affiliation></affiliation></author><author><name sortKey="Sipmann, F S" sort="Sipmann, F S" uniqKey="Sipmann F" first="F. S." last="Sipmann">F. S. Sipmann</name><affiliation><mods:affiliation>Fundacin Jimnez Daz, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Zavala, E" sort="Zavala, E" uniqKey="Zavala E" first="E." last="Zavala">E. Zavala</name><affiliation><mods:affiliation>Hospital Clinic of Barcelona, Spain</mods:affiliation></affiliation></author><author><name sortKey="Bewley, J" sort="Bewley, J" uniqKey="Bewley J" first="J." last="Bewley">J. Bewley</name><affiliation><mods:affiliation>Bristol Royal Infirmary, Bristol, UK</mods:affiliation></affiliation></author><author><name sortKey="Marx, G" sort="Marx, G" uniqKey="Marx G" first="G." last="Marx">G. Marx</name><affiliation><mods:affiliation>Friedrich-Schiller-University, Jena, Germany</mods:affiliation></affiliation></author><author><name sortKey="Vincent, J L" sort="Vincent, J L" uniqKey="Vincent J" first="J.-L." last="Vincent">J.-L. Vincent</name><affiliation><mods:affiliation>Erasme Hospital, Free University of Brussels, Belgium on behalf of the Sepsis Occurrence in Acutely Ill Patients investigators</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: jlvincen@ulb.ac.be</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">British Journal of Anaesthesia</title><title level="j" type="abbrev">Br J Anaesth</title><idno type="ISSN">0007-0912</idno><idno type="eISSN">1471-6771</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2007-02">2007-02</date><biblScope unit="volume">98</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="216">216</biblScope><biblScope unit="page" to="224">224</biblScope></imprint><idno type="ISSN">0007-0912</idno></series><idno type="istex">D68F9DBDE53F44F60A256C642806F7757808A113</idno><idno type="DOI">10.1093/bja/ael333</idno><idno type="ArticleID">ael333</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0007-0912</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The influence of hydroxyethyl starch (HES) solutions on renal function is controversial. We investigated the effect of HES administration on renal function in critically ill patients enrolled in a large multicentre observational European study. Methods All adult patients admitted to the 198 participating intensive care units (ICUs) during a 15-day period were enrolled. Prospectively collected data included daily fluid administration, urine output, sequential organ failure assessment (SOFA) score, serum creatinine levels, and the need for renal replacement therapy (RRT) during the ICU stay. Results Of 3147 patients, 1075 (34) received HES. Patients who received HES were older [mean (sd): 62 (sd17) vs 60 (18) years, P 0.022], more likely to be surgical admissions, had a higher incidence of haematological malignancy and heart failure, higher SAPS II [40.0 (17.0) vs 34.7 (16.9), P < 0.001] and SOFA [6.2 (3.7) vs 5.0 (3.9), P < 0.001] scores, and less likely to be receiving RRT (2 vs 4, P < 0.001) than those who did not receive HES. The renal SOFA score increased significantly over the ICU stay independent of the type of fluid administered. Although more patients who received HES needed RRT than non-HES patients (11 vs 9, P 0.006), HES administration was not associated with an increased risk for subsequent RRT in a multivariable analysis [odds ratio (OR): 0.417, 95 confidence interval (CI): 0.053.27, P 0.406]. Sepsis (OR: 2.03, 95 CI: 1.373.02, P < 0.001), cardiovascular failure (OR: 6.88, 95 CI: 4.4910.56, P < 0.001), haematological cancer (OR: 2.83, 95 CI: 1.286.25, P 0.01), and baseline renal SOFA scores > 1 (P < 0.01 for renal SOFA 2, 3, and 4 with renal SOFA 0 as a reference) were all associated with a higher need for RRT. Conclusions In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU. The administration of HES had no influence on renal function or the need for RRT in the ICU.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Y. Sakr</name><affiliations><json:string>Friedrich-Schiller-University, Jena, Germany</json:string></affiliations></json:item><json:item><name>D. Payen</name><affiliations><json:string>Centre Hospitalier Universitaire Lariboisiere, Paris, France</json:string></affiliations></json:item><json:item><name>K. Reinhart</name><affiliations><json:string>Friedrich-Schiller-University, Jena, Germany</json:string></affiliations></json:item><json:item><name>F. S. Sipmann</name><affiliations><json:string>Fundacin Jimnez Daz, Madrid, Spain</json:string></affiliations></json:item><json:item><name>E. Zavala</name><affiliations><json:string>Hospital Clinic of Barcelona, Spain</json:string></affiliations></json:item><json:item><name>J. Bewley</name><affiliations><json:string>Bristol Royal Infirmary, Bristol, UK</json:string></affiliations></json:item><json:item><name>G. Marx</name><affiliations><json:string>Friedrich-Schiller-University, Jena, Germany</json:string></affiliations></json:item><json:item><name>J.-L. Vincent</name><affiliations><json:string>Erasme Hospital, Free University of Brussels, Belgium on behalf of the Sepsis Occurrence in Acutely Ill Patients investigators</json:string><json:string>E-mail: jlvincen@ulb.ac.be</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Critical Care</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>complications, renal</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>fluids, i.v.</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>hydroxyethyl starch</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>kidney, failure</value></json:item></subject><articleId><json:string>ael333</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background The influence of hydroxyethyl starch (HES) solutions on renal function is controversial. We investigated the effect of HES administration on renal function in critically ill patients enrolled in a large multicentre observational European study. Methods All adult patients admitted to the 198 participating intensive care units (ICUs) during a 15-day period were enrolled. Prospectively collected data included daily fluid administration, urine output, sequential organ failure assessment (SOFA) score, serum creatinine levels, and the need for renal replacement therapy (RRT) during the ICU stay. Results Of 3147 patients, 1075 (34) received HES. Patients who received HES were older [mean (sd): 62 (sd17) vs 60 (18) years, P 0.022], more likely to be surgical admissions, had a higher incidence of haematological malignancy and heart failure, higher SAPS II [40.0 (17.0) vs 34.7 (16.9), P > 0.001] and SOFA [6.2 (3.7) vs 5.0 (3.9), P > 0.001] scores, and less likely to be receiving RRT (2 vs 4, P > 0.001) than those who did not receive HES. The renal SOFA score increased significantly over the ICU stay independent of the type of fluid administered. Although more patients who received HES needed RRT than non-HES patients (11 vs 9, P 0.006), HES administration was not associated with an increased risk for subsequent RRT in a multivariable analysis [odds ratio (OR): 0.417, 95 confidence interval (CI): 0.053.27, P 0.406]. Sepsis (OR: 2.03, 95 CI: 1.373.02, P > 0.001), cardiovascular failure (OR: 6.88, 95 CI: 4.4910.56, P > 0.001), haematological cancer (OR: 2.83, 95 CI: 1.286.25, P 0.01), and baseline renal SOFA scores > 1 (P > 0.01 for renal SOFA 2, 3, and 4 with renal SOFA 0 as a reference) were all associated with a higher need for RRT. Conclusions In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU. The administration of HES had no influence on renal function or the need for RRT in the ICU.</abstract><qualityIndicators><score>8</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612.283 x 790.866 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>2100</abstractCharCount><pdfWordCount>5295</pdfWordCount><pdfCharCount>35406</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>341</abstractWordCount></qualityIndicators><title>Effects of hydroxyethyl starch administration on renal function in critically ill patients</title><genre><json:string>research-article</json:string></genre><host><volume>98</volume><publisherId><json:string>bjaint</json:string></publisherId><pages><last>224</last><first>216</first></pages><issn><json:string>0007-0912</json:string></issn><issue>2</issue><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1471-6771</json:string></eissn><title>British Journal of Anaesthesia</title></host><categories><wos><json:string>ANESTHESIOLOGY</json:string></wos></categories><publicationDate>2007</publicationDate><copyrightDate>2007</copyrightDate><doi><json:string>10.1093/bja/ael333</json:string></doi><id>D68F9DBDE53F44F60A256C642806F7757808A113</id><score>0.10708964</score><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Effects of hydroxyethyl starch administration on renal function in critically ill patients</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>2007 The Author(s)</p></availability><date>2007</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Effects of hydroxyethyl starch administration on renal function in critically ill patients</title><author xml:id="author-1"><persName><forename type="first">Y.</forename><surname>Sakr</surname></persName><affiliation>Friedrich-Schiller-University, Jena, Germany</affiliation></author><author xml:id="author-2"><persName><forename type="first">D.</forename><surname>Payen</surname></persName><affiliation>Centre Hospitalier Universitaire Lariboisiere, Paris, France</affiliation></author><author xml:id="author-3"><persName><forename type="first">K.</forename><surname>Reinhart</surname></persName><affiliation>Friedrich-Schiller-University, Jena, Germany</affiliation></author><author xml:id="author-4"><persName><forename type="first">F. S.</forename><surname>Sipmann</surname></persName><affiliation>Fundacin Jimnez Daz, Madrid, Spain</affiliation></author><author xml:id="author-5"><persName><forename type="first">E.</forename><surname>Zavala</surname></persName><affiliation>Hospital Clinic of Barcelona, Spain</affiliation></author><author xml:id="author-6"><persName><forename type="first">J.</forename><surname>Bewley</surname></persName><affiliation>Bristol Royal Infirmary, Bristol, UK</affiliation></author><author xml:id="author-7"><persName><forename type="first">G.</forename><surname>Marx</surname></persName><affiliation>Friedrich-Schiller-University, Jena, Germany</affiliation></author><author xml:id="author-8" corresp="yes"><persName><forename type="first">J.-L.</forename><surname>Vincent</surname></persName><email>jlvincen@ulb.ac.be</email><affiliation>Erasme Hospital, Free University of Brussels, Belgium on behalf of the Sepsis Occurrence in Acutely Ill Patients investigators</affiliation></author></analytic><monogr><title level="j">British Journal of Anaesthesia</title><title level="j" type="abbrev">Br J Anaesth</title><idno type="pISSN">0007-0912</idno><idno type="eISSN">1471-6771</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2007-02"></date><biblScope unit="volume">98</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="216">216</biblScope><biblScope unit="page" to="224">224</biblScope></imprint></monogr><idno type="istex">D68F9DBDE53F44F60A256C642806F7757808A113</idno><idno type="DOI">10.1093/bja/ael333</idno><idno type="ArticleID">ael333</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2007</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background The influence of hydroxyethyl starch (HES) solutions on renal function is controversial. We investigated the effect of HES administration on renal function in critically ill patients enrolled in a large multicentre observational European study. Methods All adult patients admitted to the 198 participating intensive care units (ICUs) during a 15-day period were enrolled. Prospectively collected data included daily fluid administration, urine output, sequential organ failure assessment (SOFA) score, serum creatinine levels, and the need for renal replacement therapy (RRT) during the ICU stay. Results Of 3147 patients, 1075 (34) received HES. Patients who received HES were older [mean (sd): 62 (sd17) vs 60 (18) years, P 0.022], more likely to be surgical admissions, had a higher incidence of haematological malignancy and heart failure, higher SAPS II [40.0 (17.0) vs 34.7 (16.9), P < 0.001] and SOFA [6.2 (3.7) vs 5.0 (3.9), P < 0.001] scores, and less likely to be receiving RRT (2 vs 4, P < 0.001) than those who did not receive HES. The renal SOFA score increased significantly over the ICU stay independent of the type of fluid administered. Although more patients who received HES needed RRT than non-HES patients (11 vs 9, P 0.006), HES administration was not associated with an increased risk for subsequent RRT in a multivariable analysis [odds ratio (OR): 0.417, 95 confidence interval (CI): 0.053.27, P 0.406]. Sepsis (OR: 2.03, 95 CI: 1.373.02, P < 0.001), cardiovascular failure (OR: 6.88, 95 CI: 4.4910.56, P < 0.001), haematological cancer (OR: 2.83, 95 CI: 1.286.25, P 0.01), and baseline renal SOFA scores > 1 (P < 0.01 for renal SOFA 2, 3, and 4 with renal SOFA 0 as a reference) were all associated with a higher need for RRT. Conclusions In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU. The administration of HES had no influence on renal function or the need for RRT in the ICU.</p></abstract><textClass><keywords scheme="keyword"><list><item><term>Critical Care</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>complications, renal</term></item><item><term>fluids, i.v.</term></item><item><term>hydroxyethyl starch</term></item><item><term>kidney, failure</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2007-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">brjana</journal-id><journal-id journal-id-type="publisher-id">bjaint</journal-id><journal-title>British Journal of Anaesthesia</journal-title><abbrev-journal-title>Br J Anaesth</abbrev-journal-title><issn pub-type="ppub">0007-0912</issn><issn pub-type="epub">1471-6771</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/bja/ael333</article-id><article-id pub-id-type="publisher-id">ael333</article-id><article-categories><subj-group><subject>Critical Care</subject></subj-group></article-categories><title-group><article-title>Effects of hydroxyethyl starch administration on renal function in critically ill patients<sup><xref ref-type="fn" rid="FN1">†</xref><xref ref-type="fn" rid="FN2">‡</xref></sup></article-title><alt-title alt-title-type="left-running">Sakr <italic>et al.</italic></alt-title><alt-title alt-title-type="right-running">Hydroxyethyl starch and renal function</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sakr</surname><given-names>Y.</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Payen</surname><given-names>D.</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Reinhart</surname><given-names>K.</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Sipmann</surname><given-names>F. S.</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Zavala</surname><given-names>E.</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Bewley</surname><given-names>J.</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Marx</surname><given-names>G.</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Vincent</surname><given-names>J.-L.</given-names></name><xref ref-type="aff" rid="af6">6</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib></contrib-group><aff id="af1"><label>1</label><institution>Friedrich-Schiller-University</institution>, <addr-line>Jena</addr-line>, <country>Germany</country></aff><aff id="af2"><label>2</label><institution>Centre Hospitalier Universitaire Lariboisiere</institution>, <addr-line>Paris</addr-line>, <country>France</country></aff><aff id="af3"><label>3</label><institution>Fundación Jiménez Díaz</institution>, <addr-line>Madrid</addr-line>, <country>Spain</country></aff><aff id="af4"><label>4</label><institution>Hospital Clinic of Barcelona</institution>, <country>Spain</country></aff><aff id="af5"><label>5</label><institution>Bristol Royal Infirmary</institution>, <addr-line>Bristol</addr-line>, <country>UK</country></aff><aff id="af6"><label>6</label><addr-line>Erasme Hospital</addr-line>, <institution>Free University of Brussels</institution>, <addr-line>Belgium on behalf of the ‘Sepsis Occurrence in Acutely Ill Patients’ investigators</addr-line></aff><author-notes><corresp id="cor1"><label>*</label>Corresponding author: <addr-line>Department of Intensive Care</addr-line>, <institution>Erasme University Hospital</institution>, <addr-line>Route De Lennik 808, 1070 Brussels</addr-line>, <country>Belgium</country>. E-mail: <email>jlvincen@ulb.ac.be</email></corresp></author-notes><pub-date pub-type="ppub"><month>February</month><year>2007</year></pub-date><volume>98</volume><issue>2</issue><fpage>216</fpage><lpage>224</lpage><history><date date-type="accepted"><day>17</day><month>5</month><year>2006</year></date></history><copyright-statement>© 2007 The Author(s)</copyright-statement><copyright-year>2007</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/uk/"><p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</p></license><abstract><sec><title>Background</title><p>The influence of hydroxyethyl starch (HES) solutions on renal function is controversial. We investigated the effect of HES administration on renal function in critically ill patients enrolled in a large multicentre observational European study.</p></sec><sec><title>Methods</title><p>All adult patients admitted to the 198 participating intensive care units (ICUs) during a 15-day period were enrolled. Prospectively collected data included daily fluid administration, urine output, sequential organ failure assessment (SOFA) score, serum creatinine levels, and the need for renal replacement therapy (RRT) during the ICU stay.</p></sec><sec><title>Results</title><p>Of 3147 patients, 1075 (34%) received HES. Patients who received HES were older [mean (<sc>sd</sc>): 62 (<sc>sd</sc> 17) <italic>vs</italic> 60 (18) years, <italic>P</italic> = 0.022], more likely to be surgical admissions, had a higher incidence of haematological malignancy and heart failure, higher SAPS II [40.0 (17.0) <italic>vs</italic> 34.7 (16.9), <italic>P</italic> < 0.001] and SOFA [6.2 (3.7) <italic>vs</italic> 5.0 (3.9), <italic>P</italic> < 0.001] scores, and less likely to be receiving RRT (2 <italic>vs</italic> 4%, <italic>P</italic> < 0.001) than those who did not receive HES. The renal SOFA score increased significantly over the ICU stay independent of the type of fluid administered. Although more patients who received HES needed RRT than non-HES patients (11 <italic>vs</italic> 9%, <italic>P</italic> = 0.006), HES administration was not associated with an increased risk for subsequent RRT in a multivariable analysis [odds ratio (OR): 0.417, 95% confidence interval (CI): 0.05–3.27, <italic>P</italic> = 0.406]. Sepsis (OR: 2.03, 95% CI: 1.37–3.02, <italic>P</italic> < 0.001), cardiovascular failure (OR: 6.88, 95% CI: 4.49–10.56, <italic>P</italic> < 0.001), haematological cancer (OR: 2.83, 95% CI: 1.28–6.25, <italic>P</italic> = 0.01), and baseline renal SOFA scores > 1 (<italic>P</italic> < 0.01 for renal SOFA 2, 3, and 4 with renal SOFA = 0 as a reference) were all associated with a higher need for RRT.</p></sec><sec><title>Conclusions</title><p>In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU. The administration of HES had no influence on renal function or the need for RRT in the ICU.</p></sec></abstract><kwd-group><title>Keywords</title><kwd>complications, renal</kwd><kwd>fluids, i.v.</kwd><kwd>hydroxyethyl starch</kwd><kwd>kidney, failure</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Effects of hydroxyethyl starch administration on renal function in critically ill patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Effects of hydroxyethyl starch administration on renal function in critically ill patients</title></titleInfo><name type="personal"><namePart type="given">Y.</namePart><namePart type="family">Sakr</namePart><affiliation>Friedrich-Schiller-University, Jena, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D.</namePart><namePart type="family">Payen</namePart><affiliation>Centre Hospitalier Universitaire Lariboisiere, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K.</namePart><namePart type="family">Reinhart</namePart><affiliation>Friedrich-Schiller-University, Jena, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F. S.</namePart><namePart type="family">Sipmann</namePart><affiliation>Fundacin Jimnez Daz, Madrid, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Zavala</namePart><affiliation>Hospital Clinic of Barcelona, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">Bewley</namePart><affiliation>Bristol Royal Infirmary, Bristol, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">G.</namePart><namePart type="family">Marx</namePart><affiliation>Friedrich-Schiller-University, Jena, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">J.-L.</namePart><namePart type="family">Vincent</namePart><affiliation>Erasme Hospital, Free University of Brussels, Belgium on behalf of the Sepsis Occurrence in Acutely Ill Patients investigators</affiliation><affiliation>E-mail: jlvincen@ulb.ac.be</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><topic>Critical Care</topic></subject><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2007-02</dateIssued><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Background The influence of hydroxyethyl starch (HES) solutions on renal function is controversial. We investigated the effect of HES administration on renal function in critically ill patients enrolled in a large multicentre observational European study. Methods All adult patients admitted to the 198 participating intensive care units (ICUs) during a 15-day period were enrolled. Prospectively collected data included daily fluid administration, urine output, sequential organ failure assessment (SOFA) score, serum creatinine levels, and the need for renal replacement therapy (RRT) during the ICU stay. Results Of 3147 patients, 1075 (34) received HES. Patients who received HES were older [mean (sd): 62 (sd17) vs 60 (18) years, P 0.022], more likely to be surgical admissions, had a higher incidence of haematological malignancy and heart failure, higher SAPS II [40.0 (17.0) vs 34.7 (16.9), P < 0.001] and SOFA [6.2 (3.7) vs 5.0 (3.9), P < 0.001] scores, and less likely to be receiving RRT (2 vs 4, P < 0.001) than those who did not receive HES. The renal SOFA score increased significantly over the ICU stay independent of the type of fluid administered. Although more patients who received HES needed RRT than non-HES patients (11 vs 9, P 0.006), HES administration was not associated with an increased risk for subsequent RRT in a multivariable analysis [odds ratio (OR): 0.417, 95 confidence interval (CI): 0.053.27, P 0.406]. Sepsis (OR: 2.03, 95 CI: 1.373.02, P < 0.001), cardiovascular failure (OR: 6.88, 95 CI: 4.4910.56, P < 0.001), haematological cancer (OR: 2.83, 95 CI: 1.286.25, P 0.01), and baseline renal SOFA scores > 1 (P < 0.01 for renal SOFA 2, 3, and 4 with renal SOFA 0 as a reference) were all associated with a higher need for RRT. Conclusions In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU. The administration of HES had no influence on renal function or the need for RRT in the ICU.</abstract><subject><genre>Keywords</genre><topic>complications, renal</topic><topic>fluids, i.v.</topic><topic>hydroxyethyl starch</topic><topic>kidney, failure</topic></subject><relatedItem type="host"><titleInfo><title>British Journal of Anaesthesia</title></titleInfo><titleInfo type="abbreviated"><title>Br J Anaesth</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0007-0912</identifier><identifier type="eISSN">1471-6771</identifier><identifier type="PublisherID">bjaint</identifier><identifier type="PublisherID-hwp">brjana</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>98</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>216</start><end>224</end></extent></part></relatedItem><identifier type="istex">D68F9DBDE53F44F60A256C642806F7757808A113</identifier><identifier type="DOI">10.1093/bja/ael333</identifier><identifier type="ArticleID">ael333</identifier><accessCondition type="use and reproduction" contentType="copyright">2007 The Author(s)</accessCondition><recordInfo><recordContentSource>OUP</recordContentSource></recordInfo></mods></metadata><covers><json:item><original>true</original><mimetype>image/tiff</mimetype><extension>tiff</extension><uri>https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/covers/tiff</uri></json:item></covers><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/annexes/jpeg</uri></json:item><json:item><original>true</original><mimetype>image/gif</mimetype><extension>gif</extension><uri>https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/annexes/gif</uri></json:item></annexes><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/D68F9DBDE53F44F60A256C642806F7757808A113/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">ANESTHESIOLOGY</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/France/explor/LeHavreV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001762 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 001762 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/France
|area= LeHavreV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:D68F9DBDE53F44F60A256C642806F7757808A113
|texte= Effects of hydroxyethyl starch administration on renal function in critically ill patients
}}
| This area was generated with Dilib version V0.6.25. |  |