title: Scandinavian clinical practice guideline on choice of fluid in resuscitation of critically ill patients with acute circulatory failure.
abstract: BACKGROUND
  The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure.
  
  
  METHODS
  Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to grade the quality of evidence and to determine the strengths of the recommendations. As efficacy and harm may vary in different subpopulations of patients with acute circulatory failure, we produced recommendations for general intensive care unit (ICU) patients and those with sepsis, trauma and burn injury.
  
  
  RESULTS
  For general ICU patients and those with sepsis, we recommend using crystalloids for resuscitation rather than hydroxyethyl starch and we suggest using crystalloids rather than gelatin and albumin. For patients with trauma we recommend to use crystalloids for resuscitation rather than colloid solutions. For patients with burn injury we provide no recommendations as there are very limited data from randomised trials on fluid resuscitation in this patient population.
  
  
  CONCLUSIONS
  We recommend using crystalloid solutions rather than colloid solutions for resuscitation in the majority of critically ill patients with acute circulatory failure.
authors.affiliation: Department of Intensive Care, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Perner
authors.forename: E
authors.initials: E
authors.lastname: Junttila
authors.forename: M
authors.initials: M
authors.lastname: Haney
authors.forename: K
authors.initials: K
authors.lastname: Hreinsson
authors.forename: R
authors.initials: R
authors.lastname: Kvåle
authors.forename: P O
authors.initials: PO
authors.lastname: Vandvik
authors.forename: M H
authors.initials: MH
authors.lastname: Møller
mesh_terms: D000418:Albumins / Q000627:therapeutic use; D003102:Colloids / Q000627:therapeutic use*; D003422:Critical Care / Q000379:methods*; D000077324:Crystalloid Solutions; D005440:Fluid Therapy / Q000379:methods*; D005780:Gelatin / Q000627:therapeutic use; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use; D007552:Isotonic Solutions / Q000627:therapeutic use*; D012151:Resuscitation / Q000379:methods*; D012537:Scandinavian and Nordic Countries; D012955:Societies, Medical
chemical_list: D000418:Albumins; D003102:Colloids; D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D005780:Gelatin