title: Use of synthetic colloids in sepsis: a critical review on efficacy, safety and patient benefits.
abstract: In this narrative review, the studies and analyses are discussed that pertain to benefits and detriments of synthetic colloids versus natural colloids or crystalloids used for fluid resuscitation in sepsis and septic shock. The relative amount of fluid infusions used to reach clinical or hemodynamic end-points are reviewed, as well as potential toxicity of starch solutions on the kidney. Hence, it cannot be excluded that adverse effects partly offset beneficial hemodynamic effects that are similar to that of natural colloids, so that in most analyses a mortality benefit of synthetic colloid fluid resuscitation in sepsis and septic shock cannot be demonstrated.
authors.affiliation: Department of Intensive Care, Medisch Spectrum Twente, Enschede, The Netherlands. r.trof@mst.nl
authors.forename: R J
authors.initials: RJ
authors.lastname: Trof
authors.forename: A B J
authors.initials: AB
authors.lastname: Groeneveld
mesh_terms: D003102:Colloids / Q000627:therapeutic use*; D003422:Critical Care; D000077324:Crystalloid Solutions; D005440:Fluid Therapy; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use; D007674:Kidney Diseases / Q000139:chemically induced; D010952:Plasma Substitutes / Q000627:therapeutic use*; D012151:Resuscitation; D018805:Sepsis / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D003102:Colloids; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes