Research
Resuscitation with low volume hydroxyethylstarch 130 kDa/0.4 is not associated with acute kidney injury
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* Corresponding author: Nicolas Boussekey nboussekey@ch-tourcoing.fr
1 Intensive care and infectious disease unit, Tourcoing hospital, 135, rue du Président Coty Tourcoing BP 619, 59208 France
2 CERIM, University of Lille, Place de Verdun, Lille 59000 France
Critical Care 2010, 14:R40 doi:10.1186/cc8920
Published: 18 March 2010Abstract
Introduction
Acute kidney injury (AKI) in the ICU is associated with poorer prognosis. Hydroxyethylstarch (HES) solutions are fluid resuscitation colloids frequently used in the ICU with controversial nephrotoxic adverse effects. Our study objective was to evaluate HES impact on renal function and organ failures.
Methods
This observational retrospective study included 363 patients hospitalized for more than 72 hours in our ICU. A hundred and sixty eight patients received HES during their stay and 195 did not. We recorded patients' baseline characteristics on admission and type and volume of fluid resuscitation during the first 3 weeks of ICU stay. We also noted the evolution of urine output, the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function and end-stage kidney disease (RIFLE) classification and sepsis related organ failure assessment (SOFA) score over 3 weeks.
Results
Patients in the HES group were more severely ill on admission but AKI incidence was similar, as well as ICU mortality. The evolution of urine output (P = 0.74), RIFLE classification (P = 0.44) and SOFA score (P = 0.23) was not different. However, HES volumes administered were low (763+/-593 ml during the first 48 hours).
Conclusions
Volume expansion with low volume HES 130 kDa/0.4 was not associated with AKI.