[Colloids vs. crystalloids in fluid resuscitation for septic shock: a meta-analysis].
OBJECTIVE
To systematically review the effects of colloids compared with crystalloids in fluid resuscitation for septic shock.


METHODS
The PubMed, Embase, Cochrane Library, CBM and CNKI were searched. All randomized controlled trials (RCTs) of adult patients requiring fluid resuscitation comparing colloids vs. crystalloids were retrieved. Study selection and assessment, data collection and analyses were undertaken. Meta-analysis was done using the Cochrane Collaboration RevMan 5.0 software.


RESULTS
Nine RCTs, involving a total of 1 998 patients were included in the review. No differences were found between colloid and crystalloid resuscitation with respect to 28-day mortality [relative risk (RR) was 0.92, 95% confidence interval (95% CI) was 0.80-1.05, P=0.21], mean arterial pressure [MAP, standardized mean difference (SMD) was 1.04, 95% CI was -0.44-2.51, P=0.17] and heart rate (HR, SMD was 0.51, 95% CI was -5.84-6.86, P=0.87). But a significant difference was observed in cardiac index (CI, SMD was 0.39, 95% CI was 0.17-0.62, P=0.000 5) between two groups. Subgroup analysis suggested a statistically significant difference in CI when albumin was used in resuscitation (SMD was 0.46, 95% CI was 0.16-0.75, P=0.002). But synthetic colloids did not have such effect (P=0.07).


CONCLUSIONS
Colloids have been shown to improve CI significantly, and no differences were found between two groups with respect to 28-day mortality, MAP, HR.
Yang
Jun
J
Department of Intensive Care Unit, the Third Hospital, Beijing University, Beijing 100191, China.
Liu
Fang
F
Zhu
Xi
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003102:Colloids / Q000627:therapeutic use*; D000077324:Crystalloid Solutions; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012151:Resuscitation / Q000379:methods; D012772:Shock, Septic / Q000628:therapy*
D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions