Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis
Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we p...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Rochwerg, B. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Schlagwörter: |
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| Anmerkung: |
© Springer-Verlag Berlin Heidelberg and ESICM 2015 |
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| Übergeordnetes Werk: |
Enthalten in: Intensive care medicine - Berlin : Springer, 1975, 41(2015), 9 vom: 23. Apr., Seite 1561-1571 |
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| Übergeordnetes Werk: |
volume:41 ; year:2015 ; number:9 ; day:23 ; month:04 ; pages:1561-1571 |
| Links: |
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| DOI / URN: |
10.1007/s00134-015-3794-1 |
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| Katalog-ID: |
SPR001230522 |
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| 100 | 1 | |a Rochwerg, B. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis |
| 264 | 1 | |c 2015 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
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| 500 | |a © Springer-Verlag Berlin Heidelberg and ESICM 2015 | ||
| 520 | |a Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. | ||
| 650 | 4 | |a Sepsis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Renal replacement therapy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Fluids |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Resuscitation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Network meta-analysis |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Alhazzani, W. |4 aut | |
| 700 | 1 | |a Gibson, A |4 aut | |
| 700 | 1 | |a Ribic, C. M. |4 aut | |
| 700 | 1 | |a Sindi, A. |4 aut | |
| 700 | 1 | |a Heels-Ansdell, D. |4 aut | |
| 700 | 1 | |a Thabane, L. |4 aut | |
| 700 | 1 | |a Fox-Robichaud, A. |4 aut | |
| 700 | 1 | |a Mbuagbaw, L. |4 aut | |
| 700 | 1 | |a Szczeklik, W. |4 aut | |
| 700 | 1 | |a Alshamsi, F. |4 aut | |
| 700 | 1 | |a Altayyar, S. |4 aut | |
| 700 | 1 | |a Ip, W. |4 aut | |
| 700 | 1 | |a Li, G. |4 aut | |
| 700 | 1 | |a Wang, M. |4 aut | |
| 700 | 1 | |a Włudarczyk, A. |4 aut | |
| 700 | 1 | |a Zhou, Q. |4 aut | |
| 700 | 1 | |a Annane, D. |4 aut | |
| 700 | 1 | |a Cook, D. J. |4 aut | |
| 700 | 1 | |a Jaeschke, R. |4 aut | |
| 700 | 1 | |a Guyatt, G. H. |4 aut | |
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10.1007/s00134-015-3794-1 doi (DE-627)SPR001230522 (SPR)s00134-015-3794-1-e DE-627 ger DE-627 rakwb eng Rochwerg, B. verfasserin aut Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag Berlin Heidelberg and ESICM 2015 Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. Sepsis (dpeaa)DE-He213 Renal replacement therapy (dpeaa)DE-He213 Fluids (dpeaa)DE-He213 Resuscitation (dpeaa)DE-He213 Network meta-analysis (dpeaa)DE-He213 Alhazzani, W. aut Gibson, A aut Ribic, C. M. aut Sindi, A. aut Heels-Ansdell, D. aut Thabane, L. aut Fox-Robichaud, A. aut Mbuagbaw, L. aut Szczeklik, W. aut Alshamsi, F. aut Altayyar, S. aut Ip, W. aut Li, G. aut Wang, M. aut Włudarczyk, A. aut Zhou, Q. aut Annane, D. aut Cook, D. J. aut Jaeschke, R. aut Guyatt, G. H. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 41(2015), 9 vom: 23. Apr., Seite 1561-1571 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:41 year:2015 number:9 day:23 month:04 pages:1561-1571 https://dx.doi.org/10.1007/s00134-015-3794-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 41 2015 9 23 04 1561-1571 |
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10.1007/s00134-015-3794-1 doi (DE-627)SPR001230522 (SPR)s00134-015-3794-1-e DE-627 ger DE-627 rakwb eng Rochwerg, B. verfasserin aut Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag Berlin Heidelberg and ESICM 2015 Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. Sepsis (dpeaa)DE-He213 Renal replacement therapy (dpeaa)DE-He213 Fluids (dpeaa)DE-He213 Resuscitation (dpeaa)DE-He213 Network meta-analysis (dpeaa)DE-He213 Alhazzani, W. aut Gibson, A aut Ribic, C. M. aut Sindi, A. aut Heels-Ansdell, D. aut Thabane, L. aut Fox-Robichaud, A. aut Mbuagbaw, L. aut Szczeklik, W. aut Alshamsi, F. aut Altayyar, S. aut Ip, W. aut Li, G. aut Wang, M. aut Włudarczyk, A. aut Zhou, Q. aut Annane, D. aut Cook, D. J. aut Jaeschke, R. aut Guyatt, G. H. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 41(2015), 9 vom: 23. Apr., Seite 1561-1571 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:41 year:2015 number:9 day:23 month:04 pages:1561-1571 https://dx.doi.org/10.1007/s00134-015-3794-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 41 2015 9 23 04 1561-1571 |
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10.1007/s00134-015-3794-1 doi (DE-627)SPR001230522 (SPR)s00134-015-3794-1-e DE-627 ger DE-627 rakwb eng Rochwerg, B. verfasserin aut Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag Berlin Heidelberg and ESICM 2015 Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. Sepsis (dpeaa)DE-He213 Renal replacement therapy (dpeaa)DE-He213 Fluids (dpeaa)DE-He213 Resuscitation (dpeaa)DE-He213 Network meta-analysis (dpeaa)DE-He213 Alhazzani, W. aut Gibson, A aut Ribic, C. M. aut Sindi, A. aut Heels-Ansdell, D. aut Thabane, L. aut Fox-Robichaud, A. aut Mbuagbaw, L. aut Szczeklik, W. aut Alshamsi, F. aut Altayyar, S. aut Ip, W. aut Li, G. aut Wang, M. aut Włudarczyk, A. aut Zhou, Q. aut Annane, D. aut Cook, D. J. aut Jaeschke, R. aut Guyatt, G. H. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 41(2015), 9 vom: 23. Apr., Seite 1561-1571 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:41 year:2015 number:9 day:23 month:04 pages:1561-1571 https://dx.doi.org/10.1007/s00134-015-3794-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 41 2015 9 23 04 1561-1571 |
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10.1007/s00134-015-3794-1 doi (DE-627)SPR001230522 (SPR)s00134-015-3794-1-e DE-627 ger DE-627 rakwb eng Rochwerg, B. verfasserin aut Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag Berlin Heidelberg and ESICM 2015 Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. Sepsis (dpeaa)DE-He213 Renal replacement therapy (dpeaa)DE-He213 Fluids (dpeaa)DE-He213 Resuscitation (dpeaa)DE-He213 Network meta-analysis (dpeaa)DE-He213 Alhazzani, W. aut Gibson, A aut Ribic, C. M. aut Sindi, A. aut Heels-Ansdell, D. aut Thabane, L. aut Fox-Robichaud, A. aut Mbuagbaw, L. aut Szczeklik, W. aut Alshamsi, F. aut Altayyar, S. aut Ip, W. aut Li, G. aut Wang, M. aut Włudarczyk, A. aut Zhou, Q. aut Annane, D. aut Cook, D. J. aut Jaeschke, R. aut Guyatt, G. H. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 41(2015), 9 vom: 23. Apr., Seite 1561-1571 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:41 year:2015 number:9 day:23 month:04 pages:1561-1571 https://dx.doi.org/10.1007/s00134-015-3794-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 41 2015 9 23 04 1561-1571 |
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10.1007/s00134-015-3794-1 doi (DE-627)SPR001230522 (SPR)s00134-015-3794-1-e DE-627 ger DE-627 rakwb eng Rochwerg, B. verfasserin aut Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Springer-Verlag Berlin Heidelberg and ESICM 2015 Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. Sepsis (dpeaa)DE-He213 Renal replacement therapy (dpeaa)DE-He213 Fluids (dpeaa)DE-He213 Resuscitation (dpeaa)DE-He213 Network meta-analysis (dpeaa)DE-He213 Alhazzani, W. aut Gibson, A aut Ribic, C. M. aut Sindi, A. aut Heels-Ansdell, D. aut Thabane, L. aut Fox-Robichaud, A. aut Mbuagbaw, L. aut Szczeklik, W. aut Alshamsi, F. aut Altayyar, S. aut Ip, W. aut Li, G. aut Wang, M. aut Włudarczyk, A. aut Zhou, Q. aut Annane, D. aut Cook, D. J. aut Jaeschke, R. aut Guyatt, G. H. aut Enthalten in Intensive care medicine Berlin : Springer, 1975 41(2015), 9 vom: 23. Apr., Seite 1561-1571 (DE-627)253724104 (DE-600)1459201-0 1432-1238 nnns volume:41 year:2015 number:9 day:23 month:04 pages:1561-1571 https://dx.doi.org/10.1007/s00134-015-3794-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 41 2015 9 23 04 1561-1571 |
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Rochwerg, B. @@aut@@ Alhazzani, W. @@aut@@ Gibson, A @@aut@@ Ribic, C. M. @@aut@@ Sindi, A. @@aut@@ Heels-Ansdell, D. @@aut@@ Thabane, L. @@aut@@ Fox-Robichaud, A. @@aut@@ Mbuagbaw, L. @@aut@@ Szczeklik, W. @@aut@@ Alshamsi, F. @@aut@@ Altayyar, S. @@aut@@ Ip, W. @@aut@@ Li, G. @@aut@@ Wang, M. @@aut@@ Włudarczyk, A. @@aut@@ Zhou, Q. @@aut@@ Annane, D. @@aut@@ Cook, D. J. @@aut@@ Jaeschke, R. @@aut@@ Guyatt, G. H. @@aut@@ |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR001230522</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519193354.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201001s2015 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s00134-015-3794-1</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR001230522</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s00134-015-3794-1-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Rochwerg, B.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2015</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© Springer-Verlag Berlin Heidelberg and ESICM 2015</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Sepsis</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Renal replacement therapy</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Fluids</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Resuscitation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Network meta-analysis</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Alhazzani, W.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Gibson, A</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ribic, C. 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| author |
Rochwerg, B. |
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Rochwerg, B. misc Sepsis misc Renal replacement therapy misc Fluids misc Resuscitation misc Network meta-analysis Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis |
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Rochwerg, B. |
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Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis Sepsis (dpeaa)DE-He213 Renal replacement therapy (dpeaa)DE-He213 Fluids (dpeaa)DE-He213 Resuscitation (dpeaa)DE-He213 Network meta-analysis (dpeaa)DE-He213 |
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Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis |
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Rochwerg, B. Alhazzani, W. Gibson, A Ribic, C. M. Sindi, A. Heels-Ansdell, D. Thabane, L. Fox-Robichaud, A. Mbuagbaw, L. Szczeklik, W. Alshamsi, F. Altayyar, S. Ip, W. Li, G. Wang, M. Włudarczyk, A. Zhou, Q. Annane, D. Cook, D. J. Jaeschke, R. Guyatt, G. H. |
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fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis |
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Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis |
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Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. © Springer-Verlag Berlin Heidelberg and ESICM 2015 |
| abstractGer |
Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. © Springer-Verlag Berlin Heidelberg and ESICM 2015 |
| abstract_unstemmed |
Abstract Fluid resuscitation, along with the early administration of antibiotics, is the cornerstone of treatment for patients with sepsis. However, whether differences in resuscitation fluids impact on the requirements for renal replacement therapy (RRT) remains unclear. To examine this issue, we performed a network meta-analysis (NMA), including direct and indirect comparisons, that addressed the effect of different resuscitation fluids on the use of RRT in patients with sepsis. The data sources MEDLINE, EMBASE, ACPJC, CINAHL and Cochrane Central Register were searched up to March 2014. Eligible studies included randomized trials reported in any language that enrolled adult patients with sepsis or septic shock and addressed the use of RRT associated with alternative resuscitation fluids. The risk of bias for individual studies and the overall certainty of the evidence were assessed. Ten studies (6664 patients) that included a total of nine direct comparisons were assessed. NMA at the four-node level showed that an increased risk of receiving RRT was associated with fluid resuscitation with starch versus crystalloid [odds ratio (OR) 1.39, 95 % credibility interval (CrI) 1.17–1.66, high certainty]. The data suggested no difference between fluid resuscitation with albumin and crystalloid (OR 1.04, 95 % CrI 0.78–1.38, moderate certainty) or starch (OR 0.74, 95 % CrI 0.53–1.04, low certainty). NMA at the six-node level showed a decreased risk of receiving RRT with balanced crystalloid compared to heavy starch (OR 0.50, 95 % CrI 0.34–0.74, moderate certainty) or light starch (OR 0.70, 95 % CrI 0.49–0.99, high certainty). There was no significant difference between balanced crystalloid and saline (OR 0.85, 95 % CrI 0.56–1.30, low certainty) or albumin (OR 0.82, 95 % CrI 0.49–1.37, low certainty). Of note, these trials vary in terms of case mix, fluids evaluated, duration of fluid exposure and risk of bias. Imprecise estimates contributed to low confidence in most estimates of effect. Among the patients with sepsis, fluid resuscitation with crystalloids compared to starch resulted in reduced use of RRT; the same may be true for albumin versus starch. © Springer-Verlag Berlin Heidelberg and ESICM 2015 |
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| score |
7.399728 |