关键词: 脓毒症, 羟乙基淀粉, 急性肾损伤

Abstract:

Debate on use of hydroxyethyl starch for fluid resuscitation in septic patients        MA Peng-lin. Department of SICU，the 309th Hospital of Chinese People’s Liberation Army，Beijing 100091，China
Abstract    Fluid resuscitation is the most important elementary care in the management of sepsis. In recent years，choice of fluid types has become one of the hot debate topics in the field. Based on recent RCTs，use of hydroxyethyl starch 130/0.4 or 0.42(HES 130/0.4 or 0.42) for volume therapy has been associated with an increased need of renal replacement therapy (RRT) notably and high risk of 90-day mortality in septic patients significantly. According to a systematical and intensive analysis on the available published data，evidence was insufficient for identifying HES 130/0.4 or 0.42-induced acute kidney injury (AKI) in patients with sepsis. Furthermore，a high heterogeneity on HES 130/0.4 or 0.42 associated mortality was found among RCTs in comparison with crystalloids in septic patients. And the results of HES 130/0.4 or 0.42 associated increase of mortality were likely confounded in the original trials. Therefore，further valid data is needed for objectively evaluating the safety of HES 130/0.4 or 0.42 administration for volume therapy in patients with sepsis.

Key words: sepsis, hydroxyethyl starch, AKI