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Danish medical journal · Feb 2015
Observational StudyMore complications in patients with septic shock treated with dextran compared with crystalloids.
- Anders Mølgaard Rasmussen, Rasmus Jakobsen, Thomas Strøm, Marcela Carlsson, Bjarne Dahler-Eriksen, and Palle Toft.
- Anæstesi- og intensivafdeling V, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense C, Denmark. a.moelgaard.rasmussen@gmail.com.
- Dan Med J. 2015 Feb 1;62(2).
IntroductionIn 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.MethodsWe 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.ResultsThere 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).ConclusionPatients 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.
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