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Mon Sep 26 13:42:18 BST 2011

The HES study will be very important both for the military and the
civilian side. I am aware of the albumin study, however at this moment
(I am in Peru with PTHLS and TCCC. We just started TCCC Latin America in
Ecuador) I do not have access to that study. Was there and arm with non
TBI patients? If so what was the outcome?

Norman

Professor, Tulane University, Surgery
Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO
New Orleans, Louisiana
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Ian Seppelt
Sent: Monday, September 26, 2011 5:21 AM
To: Trauma-List [TRAUMA.ORG]
Cc: Trauma-List [TRAUMA.ORG]
Subject: Re: trauma ressuscitation

SAFE of course included over 1000 trauma patients in an RCT of saline vs
albumin for fluid resuscitation (conclusion - worse outcome using
albumin in the trauma cohort, which turned out to be the traumatic brain
injury group if subsequent analysis and followup).

There is a similar 7000 patient RCT of saline vs 125/0.4 HES (Voluven)
underway at present, similarly expecting about 1000 trauma patients as
one predefined cohort.

Ian

Sent from my iPad

On 25/09/2011, at 11:07 PM, "McSwain, Norman E" <nmcswai at tulane.edu>
wrote:

> Most of the data with Hextend and similar compounds have NOT shown any
> outcome differences. However there have been no randomized prospective
> studies. The major studies have come out of Miami and are only
> comparisons of some surgeons who used and other who did not. These
> studies are not good comparisons and cannot be used to comment on the
> outcome. 
> 
> Because of the research rules of informed consent such RP studies are
> very hard to do in the US. Someone who does not have these limitations
> should do a good RP study
> 
> The benefit for the military is that these colloids are much lighter
to
> carry and require less space (500cc vs 1000 cc). That provides a
> significant difference when on a mission.
> 
> Bottom line. Colloids like Hextend should reduce the edema problems of
> crystalloid use but no one knows for sure so the best management is
> probably plasma and RBC with no crystalloid or colloids
> 
> Norman
> 
> Professor, Tulane University, Surgery
> Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO
> New Orleans, Louisiana
> 504 988 5111
> 
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of rm khattar
> Sent: Sunday, September 25, 2011 7:45 AM
> To: trauma-list at trauma.org
> Subject: trauma ressuscitation
> 
> I have read so much in last few years on this list about permissive
> hypotension,role of crystalloids etc.
> Kindly educate me regarding, place of plasma expanders in trauma
> resuscitation,[Hypovolemic shock]and septic shock.
> Thanks
> R.M.Khattar
> Delhi India.
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