Preferences for colloid use in Scandinavian intensive care units

Background: Fluid resuscitation is a frequent intervention in intensive care. Colloids are widely used, but recent data suggest harm by some of these solutions. This calls for more clinical studies on this matter, but the current preferences for colloid use in Scandinavian intensive care units (ICUs...

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Veröffentlicht in:Acta anaesthesiologica Scandinavica 2008-07, Vol.52 (6), p.750-758
Hauptverfasser: FLUIDS study investigators for the Scandinavian Critical Care Trials Group, The FLUIDS study investigators for the Scandinavian Critical Care Trials Group
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description Background: Fluid resuscitation is a frequent intervention in intensive care. Colloids are widely used, but recent data suggest harm by some of these solutions. This calls for more clinical studies on this matter, but the current preferences for colloid use in Scandinavian intensive care units (ICUs) are unknown. Methods: In March–May 2007, 120 Scandinavian ICUs were invited to answer a web‐based survey consisting of 18 questions on types of colloids, indications, contraindications and rationale of use. Results: Seventy‐three ICUs, of which 31 were university hospital units, answered the questionnaire. Most ICUs used both synthetic and natural colloids, and hydroxyethyl starch (HES) 130/0.4 was the preferred colloid in 59 units. Eleven ICUs had protocols for colloid use. The most frequent indication was second‐line fluid for hypovolaemia, but one in three ICUs used colloids as first‐line fluid. Thirty‐five ICUs had contraindications, which were mainly for the use of synthetic colloids (acute renal failure 25 units, bleeding 15 units). Most units based the use of colloids on theoretical knowledge and tradition. Sixty‐five and 54 ICUs were ready to change colloid use based on data from randomised trials of ICU patients showing changes in mortality or renal function, respectively. Conclusion: Most Scandinavian ICUs use both synthetic and natural colloids, but HES 130/0.4 is by far the preferred colloid. Few units have protocols for colloid use, but most use them for hypovolaemia, and the majority have no contraindications. Most ICUs are ready to change colloid use if randomised trials in ICU patients show changes in mortality or renal function.
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Colloids are widely used, but recent data suggest harm by some of these solutions. This calls for more clinical studies on this matter, but the current preferences for colloid use in Scandinavian intensive care units (ICUs) are unknown. Methods: In March–May 2007, 120 Scandinavian ICUs were invited to answer a web‐based survey consisting of 18 questions on types of colloids, indications, contraindications and rationale of use. Results: Seventy‐three ICUs, of which 31 were university hospital units, answered the questionnaire. Most ICUs used both synthetic and natural colloids, and hydroxyethyl starch (HES) 130/0.4 was the preferred colloid in 59 units. Eleven ICUs had protocols for colloid use. The most frequent indication was second‐line fluid for hypovolaemia, but one in three ICUs used colloids as first‐line fluid. Thirty‐five ICUs had contraindications, which were mainly for the use of synthetic colloids (acute renal failure 25 units, bleeding 15 units). Most units based the use of colloids on theoretical knowledge and tradition. Sixty‐five and 54 ICUs were ready to change colloid use based on data from randomised trials of ICU patients showing changes in mortality or renal function, respectively. Conclusion: Most Scandinavian ICUs use both synthetic and natural colloids, but HES 130/0.4 is by far the preferred colloid. Few units have protocols for colloid use, but most use them for hypovolaemia, and the majority have no contraindications. Most ICUs are ready to change colloid use if randomised trials in ICU patients show changes in mortality or renal function.</description><identifier>ISSN: 0001-5172</identifier><identifier>EISSN: 1399-6576</identifier><identifier>DOI: 10.1111/j.1399-6576.2008.01690.x</identifier><identifier>PMID: 18582303</identifier><identifier>CODEN: AANEAB</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Colloids ; Colloids - therapeutic use ; Contraindications ; fluid therapy ; Fluid Therapy - methods ; Health Care Surveys ; Humans ; Hydroxyethyl Starch Derivatives - therapeutic use ; intensive care ; Intensive Care Units ; Medical sciences ; Plasma Substitutes - therapeutic use ; plasma volume expanders ; Scandinavian and Nordic Countries ; Surveys and Questionnaires</subject><ispartof>Acta anaesthesiologica Scandinavica, 2008-07, Vol.52 (6), p.750-758</ispartof><rights>2008 The Authors. 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Colloids are widely used, but recent data suggest harm by some of these solutions. This calls for more clinical studies on this matter, but the current preferences for colloid use in Scandinavian intensive care units (ICUs) are unknown. Methods: In March–May 2007, 120 Scandinavian ICUs were invited to answer a web‐based survey consisting of 18 questions on types of colloids, indications, contraindications and rationale of use. Results: Seventy‐three ICUs, of which 31 were university hospital units, answered the questionnaire. Most ICUs used both synthetic and natural colloids, and hydroxyethyl starch (HES) 130/0.4 was the preferred colloid in 59 units. Eleven ICUs had protocols for colloid use. The most frequent indication was second‐line fluid for hypovolaemia, but one in three ICUs used colloids as first‐line fluid. Thirty‐five ICUs had contraindications, which were mainly for the use of synthetic colloids (acute renal failure 25 units, bleeding 15 units). Most units based the use of colloids on theoretical knowledge and tradition. Sixty‐five and 54 ICUs were ready to change colloid use based on data from randomised trials of ICU patients showing changes in mortality or renal function, respectively. Conclusion: Most Scandinavian ICUs use both synthetic and natural colloids, but HES 130/0.4 is by far the preferred colloid. Few units have protocols for colloid use, but most use them for hypovolaemia, and the majority have no contraindications. Most ICUs are ready to change colloid use if randomised trials in ICU patients show changes in mortality or renal function.</description><subject>Adult</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Colloids</topic><topic>Colloids - therapeutic use</topic><topic>Contraindications</topic><topic>fluid therapy</topic><topic>Fluid Therapy - methods</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Hydroxyethyl Starch Derivatives - therapeutic use</topic><topic>intensive care</topic><topic>Intensive Care Units</topic><topic>Medical sciences</topic><topic>Plasma Substitutes - therapeutic use</topic><topic>plasma volume expanders</topic><topic>Scandinavian and Nordic Countries</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FLUIDS study investigators for the Scandinavian Critical Care Trials Group</creatorcontrib><creatorcontrib>The FLUIDS study investigators for the Scandinavian Critical Care Trials Group</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta anaesthesiologica Scandinavica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><aucorp>FLUIDS study investigators for the Scandinavian Critical Care Trials Group</aucorp><aucorp>The FLUIDS study investigators for the Scandinavian Critical Care Trials Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preferences for colloid use in Scandinavian intensive care units</atitle><jtitle>Acta anaesthesiologica Scandinavica</jtitle><addtitle>Acta Anaesthesiol Scand</addtitle><date>2008-07</date><risdate>2008</risdate><volume>52</volume><issue>6</issue><spage>750</spage><epage>758</epage><pages>750-758</pages><issn>0001-5172</issn><eissn>1399-6576</eissn><coden>AANEAB</coden><abstract>Background: Fluid resuscitation is a frequent intervention in intensive care. 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subjects Adult
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Colloids
Colloids - therapeutic use
Contraindications
fluid therapy
Fluid Therapy - methods
Health Care Surveys
Humans
Hydroxyethyl Starch Derivatives - therapeutic use
intensive care
Intensive Care Units
Medical sciences
Plasma Substitutes - therapeutic use
plasma volume expanders
Scandinavian and Nordic Countries
Surveys and Questionnaires
title Preferences for colloid use in Scandinavian intensive care units
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