PMID- 20165941
OWN - NLM
STAT- MEDLINE
DCOM- 20100610
LR  - 20240222
IS  - 1432-1238 (Electronic)
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 36
IP  - 4
DP  - 2010 Apr
TI  - Greater cardiac response of colloid than saline fluid loading in septic and 
      non-septic critically ill patients with clinical hypovolaemia.
PG  - 697-701
LID - 10.1007/s00134-010-1776-x [doi]
AB  - BACKGROUND AND OBJECTIVE: The haemodynamics of crystalloid and colloid fluid 
      loading may depend on underlying disease, i.e. sepsis versus non-sepsis. DESIGN 
      AND SETTING: A single-centre, single-blinded, randomized clinical trial was 
      carried out on 24 critically ill sepsis and 24 non-sepsis patients with clinical 
      hypovolaemia, assigned to loading with normal saline, gelatin 4%, hydroxyethyl 
      starch 6% or albumin 5% in a 90-min (delta) central venous pressure (CVP)-guided 
      fluid loading protocol. Transpulmonary thermodilution was done each 30 min, 
      yielding, among others, global end-diastolic volume and cardiac indices (GEDVI, 
      CI). RESULTS: Sepsis patients had hyperdynamic hypotension in spite of myocardial 
      depression and dilatation, and greater inotropic/vasopressor requirements than 
      non-sepsis patients. Independent of underlying disease, CVP and GEDVI increased 
      more after colloid than saline loading (P < 0.018), so that CI increased by about 
      2% after saline and 12% after colloid loading (P = 0.029). The increase in 
      preload-recruitable stroke work was also greater with colloids and did not differ 
      among conditions. CONCLUSION: Fluid loading with colloids results in a greater 
      linear increase in cardiac filling, output and stroke work than does saline 
      loading, in both septic and non-septic clinical hypovolaemia, in spite of 
      myocardial depression and presumably increased vasopermeability potentially 
      decreasing the effects of colloid fluid loading in the former.
FAU - Trof, Ronald J
AU  - Trof RJ
AD  - Department of Intensive Care, Medical Spectrum Twente, Haaksbergerstraat 55, 7513 
      ER, Enschede, The Netherlands.
FAU - Sukul, Sharwan P
AU  - Sukul SP
FAU - Twisk, Jos W R
AU  - Twisk JW
FAU - Girbes, Armand R J
AU  - Girbes AR
FAU - Groeneveld, A B Johan
AU  - Groeneveld AB
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20100218
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
RN  - 0 (Albumins)
RN  - 0 (Crystalloid Solutions)
RN  - 0 (Hydroxyethyl Starch Derivatives)
RN  - 0 (Isotonic Solutions)
RN  - 0 (Plasma Substitutes)
RN  - 0 (Saline Solution, Hypertonic)
RN  - 9000-70-8 (Gelatin)
SB  - IM
MH  - APACHE
MH  - Adult
MH  - Aged
MH  - Albumins/therapeutic use
MH  - Cardiac Output
MH  - Chi-Square Distribution
MH  - Critical Illness
MH  - Crystalloid Solutions
MH  - Female
MH  - Fluid Therapy/*methods
MH  - Gelatin/therapeutic use
MH  - Humans
MH  - Hydroxyethyl Starch Derivatives/therapeutic use
MH  - Hypovolemia/*etiology/physiopathology/*therapy
MH  - Isotonic Solutions/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Plasma Substitutes/*therapeutic use
MH  - Prospective Studies
MH  - Saline Solution, Hypertonic/therapeutic use
MH  - Sepsis/*complications/physiopathology
MH  - Single-Blind Method
MH  - Statistics, Nonparametric
MH  - Treatment Outcome
PMC - PMC2837190
EDAT- 2010/02/19 06:00
MHDA- 2010/06/11 06:00
PMCR- 2010/02/18
CRDT- 2010/02/19 06:00
PHST- 2009/04/08 00:00 [received]
PHST- 2009/10/18 00:00 [accepted]
PHST- 2010/02/19 06:00 [entrez]
PHST- 2010/02/19 06:00 [pubmed]
PHST- 2010/06/11 06:00 [medline]
PHST- 2010/02/18 00:00 [pmc-release]
AID - 1776 [pii]
AID - 10.1007/s00134-010-1776-x [doi]
PST - ppublish
SO  - Intensive Care Med. 2010 Apr;36(4):697-701. doi: 10.1007/s00134-010-1776-x. Epub 
      2010 Feb 18.