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Thu, 21 Nov 2002 10:46:52 -0000

> While the topic of fluid resuscitation is up, I was wondering what
> anyone's thoughts/opinions/practical experiences are regarding Hespan
> (6% Hetastarch in water).  I've read mixed reviews about its usage in
> volume replacement for the trauma patient and just figured 
> I'd throw it
> on the table for discussion. 

This has been batted around for many years now. To summarise the evidence on
colloid resuscitation: There have been numerous studies using various forms
of colloid in various conditions. There has never been any benefit shown for
any form of colloid. Crystalloid is cheaper and works as well. Many
pointless words have been said about which colloid to use, but none of them
have any benefit over crystalloid. The only people who gain anything from
this debate are the manufacturers of colloid solutions who somehow still
manage to find a market for a product that is expensive and ineffective. Do
not be fooled by people saying 'But the evidence doesn't apply here because
this particular colloid has not been studied in this particular group of
patients (age group; trauma/ sepsis; pre- op/ post- op etc.). Type in
'systematic review' and 'fluid resuscitation' to your search engine to find
the references.

Matt Dunn
Warwick

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Colloid resuscitation