Study compares risk of death of fluid replacement therapies for critically ill patients
2013-10-09
(Press-News.org) Djillali Annane, M.D., Ph.D., of Raymond Poincare Hospital, Garches, France, and colleagues conducted a study to compare the effects of 2 types of intravenous fluids on survival for critically ill patients in an intensive care unit.
Thousands of patients in intensive care units (ICUs) throughout the world are treated every day with intravenous fluids, mainly to restore effective blood volume and perfusion of organs. Fluid therapy includes a broad variety of products that are categorized as crystalloids and colloids: crystalloids are salts; colloids are salts and gelatin, starch or protein. Compared with crystalloids, colloid solutions expand blood volume and last longer. However, colloids may increase illness and death in critically ill patients and many physicians considered crystalloids the best fluid therapy in this population, according to background information in the article.
The trial included 2,857 ICU patients who required fluid resuscitation for sepsis or trauma, or hypovolemic (decreased blood volume) shock for patients without sepsis or trauma at 57 intensive care units in France, Belgium, North Africa, and Canada. Recruitment into the trial started in February 2003 and ended in August 2012 with follow-up until November 2012. Patients were randomly assigned to crystalloids (n = 1,443) or colloids (n = 1,414) for all fluid intervention (except fluid maintenance) throughout their ICU stay. The primary outcome was death within 28 days.
The study reports no difference in outcomes between groups; there were 359 deaths (25.4 percent) among patients treated with colloids vs. 390 deaths (27.0 percent) among patients treated with crystalloids. At 90 days, there were 434 deaths (30.7 percent) among patients treated with colloids vs. 493 deaths (34.2 percent) among patients treated with crystalloids.
"In conclusion, among ICU patients with hypovolemia, the use of colloids compared with crystalloids did not result in a significant difference in 28-day mortality. Although 90-day mortality was lower among patients receiving colloids, this finding should be considered exploratory and requires further study before reaching conclusions about efficacy," the authors write.
###
(doi:10.l001/jama.2013.280502; Available pre-embargo to the media at http://media.jamanetwork.com)
END
ELSE PRESS RELEASES FROM THIS DATE:
2013-10-09
Andrea Morelli, M.D., of the University of Rome, Italy, and colleagues conducted a study to investigate the effect of the short-acting beta-blocker esmolol on the heart rate of patients with severe septic shock and high risk of death.
Septic shock is associated with adverse effects on cardiac function. Beta-blocker therapy controls heart rate and may improve cardiovascular performance, but concerns remain that this therapy may lead to cardiovascular decompensation (inability of the heart to maintain adequate circulation), according to background information in the article. ...
2013-10-09
Researchers working at the University of Saskatchewan have discovered new potential in prairie fruits, in particular, buffaloberry, chokecherry and sea buckthorn, according to a new study published today in the Canadian Journal of Plant Science. Findings showed that these fruits were nutrient-rich and that the potential food value is high. This is good news for fruit growers in Saskatchewan as these results add further credence to support the development of these fruits for commercial food markets.
"There is increasing interest in the commercial development of these ...
2013-10-09
The German Institute for Quality and Efficiency in Health Care (IQWiG) analysed additional data on drugs from the group of gliptins. The drug manufacturers had subsequently submitted these data to the Federal Joint Committee (G-BA) in the commenting procedure. The Institute came to a different conclusion on the fixed combination of sitagliptin/metformin: As for the single agent sitagliptin before, there are now hints of an added benefit for this fixed combination. However, IQWiG still does not see any advantages of vildagliptin and the fixed combination of vildagliptin ...
2013-10-09
New York University chemists have discovered crystal growth complexities, which at first glance appeared to confound 50 years of theory and deepened the mystery of how organic crystals form. But, appearances can be deceiving.
Their findings, which appear in the latest edition of Proceedings of the National Academy of Sciences, have a range of implications -- from the production of pharmaceuticals and new electronic materials to unraveling the pathways for kidney stone formation.
The researchers focused on L-cystine crystals, the chief component of a particularly nefarious ...
2013-10-09
This news release is available in German.
Jorg Massen (University of Vienna) and Sonja Koski (University of Zurich) together measured chimpanzee personality in two zoos with behavioural experiments and years of observations of chimpanzee behaviour. They also carefully logged which chimpanzee sat in body contact with whom most. "This is a clear sign of friendship among chimpanzees", explains Jorg Massen. Subsequently, the researchers tested, if those chimpanzees who sit together frequently have similar or different personality types.
"We found that, especially ...
2013-10-09
COLUMBUS, Ohio – Kindergarten-age children have poorer health if their home life is marked by disorder, noise and a lack of routine and they have a mother who has a chaotic work life, new research suggests.
The results show the importance of order and routine in helping preschoolers stay healthy and develop to the best of their potential, said Claire Kamp Dush, lead author of the study and assistant professor of human sciences at The Ohio State University.
"Children need to have order in their lives," Kamp Dush said. "When their life is chaotic and not predictable, ...
2013-10-09
In 2012 researchers from the German Institute for Quality and Efficiency in Health Care (IQWiG) presented a study in the BMJ analysing information sources used in 16 health technology assessment (HTA) reports of drugs ("benefit assessments"). This study clearly demonstrated that publicly available sources, such as scientific journals and entries posted in trial registries ("registry reports"), contained far less information on methods and outcomes of clinical trials than non-public CSRs prepared by pharmaceutical companies.
In a second article published today in PLOS ...
2013-10-09
An international team of scientists—including researchers at GENYO, the Centre for Genomics and Oncological Research (Pfizer-University of Granada- Andalusian Regional Government)—has described a molecular mechanism that facilitates the defence of the human genome against "bombarding" by mobile DNA sequences. Abnormalities in the mechanism could be responsible for some symptoms of DiGeorge syndrome, a rare disease. The research could in the future help develop new therapies against the disease, which is caused by the microdeletion of a small part of chromosome 22.
The ...
2013-10-09
Researchers at Karolinska Institutet in Sweden and their Danish colleagues have monitored HPV-vaccinated girls via patient data registries in order to examine the incidence of a wide range of diseases and thus determine if there are any serious adverse effects of the vaccine. Their results show no significant increase of the examined diseases in the vaccinated girls relative to their unvaccinated peers.
The study included almost a million Swedish and Danish girls born between 1988 and 2000, and compared roughly 300,000 girls who had been HPV vaccinated with 700,000 who ...
2013-10-09
PHILADELPHIA—Patients who received care at multiple HIV clinics—as opposed to only one— were less likely to take their medication and had higher HIV viral loads, a new study published in the journal AIDS and Behavior of almost 13,000 HIV patients in Philadelphia from Penn Medicine found. The findings reinforce the notion that continuous care with one provider/clinic is optimal for outcomes and even reducing transmissions, and can help cut down on duplicative HIV services that contribute to higher health care costs.
"It's about retention in care, but also continuity, ...
LAST 30 PRESS RELEASES:
[Press-News.org] Study compares risk of death of fluid replacement therapies for critically ill patients
