title: More complications in patients with septic shock treated with dextran compared with crystalloids.
abstract: BACKGROUND
  In recent years, the safety-profile of synthetic colloids has been questioned. The purpose of the present study was to elucidate the safety-profile of the colloid dextran-70 in relation to acute kidney injury (AKI) and death.
  
  
  METHODS
  We conducted a retrospective, observational study of patients admitted to our intensive care unit with septic shock and treated with dextran-70 in the period from 1 January 2009 to 31 December 2009. The controls were included from 1 March 2012 to 28 February 2013 when dextran-70 was replaced with crystalloids.
  
  
  RESULTS
  There were 91 patients in the dextran group and 150 patients in the non-dextran group. The urinary output was 17.93 ml/kg/24 h in the dextran group and 27.87 in the non-dextran group (p < 0.05). Continuous renal replacement therapy (CRRT) was used in 48% in the dextran group and in 23% in the non-dextran group (p < 0.05). Major bleeding episodes occurred in 32% in the dextran group compared with 15% in the control group (p < 0.05). The 90-day mortality was 42% in the dextran group and 35% in the non-dextran group (p = 0.08).
  
  
  CONCLUSIONS
  Patients in the dextran group had significantly more bleeding episodes, a higher need for CRRT and a lower urinary output than patients in the non-dextran group. Due to study design, it cannot be concluded that the use of dextran-70 is causally related to the development of AKI.
authors: Anæstesi- og intensivafdeling V, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense C, Denmark. a.moelgaard.rasmussen@gmail.com.
authors: Anders Mølgaard
authors: AM
authors: Rasmussen
authors: Rasmus
authors: R
authors: Jakobsen
authors: Thomas
authors: T
authors: Strøm
authors: Marcela
authors: M
authors: Carlsson
authors: Bjarne
authors: B
authors: Dahler-Eriksen
authors: Palle
authors: P
authors: Toft
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000401:mortality; D000368:Aged; D000077324:Crystalloid Solutions; D003911:Dextrans / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000401:mortality; D006801:Humans; D007362:Intensive Care Units; D007552:Isotonic Solutions / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000009:adverse effects*; D017582:Renal Replacement Therapy / Q000379:methods; D012189:Retrospective Studies; D012772:Shock, Septic / Q000188:drug therapy*; D014556:Urine
chemical_list: D000077324:Crystalloid Solutions; D003911:Dextrans; D007552:Isotonic Solutions; D010952:Plasma Substitutes