Is hydroxyethyl starch safe in penetrating trauma patients?

Casey J. Allen, Xiomara D. Ruiz, Jonathan P. Meizoso, Juliet J. Ray, Alan Livingstone, Carl I Schulman, Nicholas Namias, Kenneth G Proctor

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: For logistic reasons, a bolus of 6% hydroxyethyl starch (HES 450/0.7 in lactated electrolyte injection) is recommended for battlefield resuscitation even though it has risks of mortality and acute kidney injury (AKI) in certain patient populations. The purpose of this study was to test the hypothesis that victims of penetrating trauma have no increased risks of AKI and/or death when receiving a single bolus of HES during initial fluid resuscitation. Methods: 816 consecutive admissions with penetrating trauma were reviewed. Patients who died within 24 hours were excluded. Propensity scores and a 1:1 fixed ratio nearest neighbor matching were used to compare those who received HES to those who did not. Data were expressed as mean ± SD and significance was assessed at p < 0.05. Results: The cohort was 88% male, age 35 ± 14 years, injury severity score of 10 ± 10, with a 3.8% rate of AKI, and 3.2% rate of mortality. HES was administered to 121 (14.8%) patients. In HES and no HES propensity matched groups, the rate of AKI was 3.8% vs. 4.8% (p = 0.749) and the 90-day mortality rate was 3.8% vs. 4.8% (p = 0.749). Conclusion: An increased risk of mortality or AKI was not observed in penetrating trauma patients who were resuscitated with low volume HES.

Original languageEnglish (US)
Pages (from-to)152-155
Number of pages4
JournalMilitary Medicine
Volume181
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Acute Kidney Injury
Starch
Wounds and Injuries
Mortality
Resuscitation
Propensity Score
Injury Severity Score
Electrolytes
Research Design
Injections
Population

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health

Cite this

Is hydroxyethyl starch safe in penetrating trauma patients? / Allen, Casey J.; Ruiz, Xiomara D.; Meizoso, Jonathan P.; Ray, Juliet J.; Livingstone, Alan; Schulman, Carl I; Namias, Nicholas; Proctor, Kenneth G.

In: Military Medicine, Vol. 181, No. 5, 01.05.2016, p. 152-155.

Research output: Contribution to journalArticle

Allen, Casey J. ; Ruiz, Xiomara D. ; Meizoso, Jonathan P. ; Ray, Juliet J. ; Livingstone, Alan ; Schulman, Carl I ; Namias, Nicholas ; Proctor, Kenneth G. / Is hydroxyethyl starch safe in penetrating trauma patients?. In: Military Medicine. 2016 ; Vol. 181, No. 5. pp. 152-155.
@article{21703797651a400db79867e84efefde7,
title = "Is hydroxyethyl starch safe in penetrating trauma patients?",
abstract = "Objectives: For logistic reasons, a bolus of 6{\%} hydroxyethyl starch (HES 450/0.7 in lactated electrolyte injection) is recommended for battlefield resuscitation even though it has risks of mortality and acute kidney injury (AKI) in certain patient populations. The purpose of this study was to test the hypothesis that victims of penetrating trauma have no increased risks of AKI and/or death when receiving a single bolus of HES during initial fluid resuscitation. Methods: 816 consecutive admissions with penetrating trauma were reviewed. Patients who died within 24 hours were excluded. Propensity scores and a 1:1 fixed ratio nearest neighbor matching were used to compare those who received HES to those who did not. Data were expressed as mean ± SD and significance was assessed at p < 0.05. Results: The cohort was 88{\%} male, age 35 ± 14 years, injury severity score of 10 ± 10, with a 3.8{\%} rate of AKI, and 3.2{\%} rate of mortality. HES was administered to 121 (14.8{\%}) patients. In HES and no HES propensity matched groups, the rate of AKI was 3.8{\%} vs. 4.8{\%} (p = 0.749) and the 90-day mortality rate was 3.8{\%} vs. 4.8{\%} (p = 0.749). Conclusion: An increased risk of mortality or AKI was not observed in penetrating trauma patients who were resuscitated with low volume HES.",
author = "Allen, {Casey J.} and Ruiz, {Xiomara D.} and Meizoso, {Jonathan P.} and Ray, {Juliet J.} and Alan Livingstone and Schulman, {Carl I} and Nicholas Namias and Proctor, {Kenneth G}",
year = "2016",
month = "5",
day = "1",
doi = "10.7205/MILMED-D-15-00132",
language = "English (US)",
volume = "181",
pages = "152--155",
journal = "Military Medicine",
issn = "0026-4075",
publisher = "Association of Military Surgeons of the US",
number = "5",

}

TY - JOUR

T1 - Is hydroxyethyl starch safe in penetrating trauma patients?

AU - Allen, Casey J.

AU - Ruiz, Xiomara D.

AU - Meizoso, Jonathan P.

AU - Ray, Juliet J.

AU - Livingstone, Alan

AU - Schulman, Carl I

AU - Namias, Nicholas

AU - Proctor, Kenneth G

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Objectives: For logistic reasons, a bolus of 6% hydroxyethyl starch (HES 450/0.7 in lactated electrolyte injection) is recommended for battlefield resuscitation even though it has risks of mortality and acute kidney injury (AKI) in certain patient populations. The purpose of this study was to test the hypothesis that victims of penetrating trauma have no increased risks of AKI and/or death when receiving a single bolus of HES during initial fluid resuscitation. Methods: 816 consecutive admissions with penetrating trauma were reviewed. Patients who died within 24 hours were excluded. Propensity scores and a 1:1 fixed ratio nearest neighbor matching were used to compare those who received HES to those who did not. Data were expressed as mean ± SD and significance was assessed at p < 0.05. Results: The cohort was 88% male, age 35 ± 14 years, injury severity score of 10 ± 10, with a 3.8% rate of AKI, and 3.2% rate of mortality. HES was administered to 121 (14.8%) patients. In HES and no HES propensity matched groups, the rate of AKI was 3.8% vs. 4.8% (p = 0.749) and the 90-day mortality rate was 3.8% vs. 4.8% (p = 0.749). Conclusion: An increased risk of mortality or AKI was not observed in penetrating trauma patients who were resuscitated with low volume HES.

AB - Objectives: For logistic reasons, a bolus of 6% hydroxyethyl starch (HES 450/0.7 in lactated electrolyte injection) is recommended for battlefield resuscitation even though it has risks of mortality and acute kidney injury (AKI) in certain patient populations. The purpose of this study was to test the hypothesis that victims of penetrating trauma have no increased risks of AKI and/or death when receiving a single bolus of HES during initial fluid resuscitation. Methods: 816 consecutive admissions with penetrating trauma were reviewed. Patients who died within 24 hours were excluded. Propensity scores and a 1:1 fixed ratio nearest neighbor matching were used to compare those who received HES to those who did not. Data were expressed as mean ± SD and significance was assessed at p < 0.05. Results: The cohort was 88% male, age 35 ± 14 years, injury severity score of 10 ± 10, with a 3.8% rate of AKI, and 3.2% rate of mortality. HES was administered to 121 (14.8%) patients. In HES and no HES propensity matched groups, the rate of AKI was 3.8% vs. 4.8% (p = 0.749) and the 90-day mortality rate was 3.8% vs. 4.8% (p = 0.749). Conclusion: An increased risk of mortality or AKI was not observed in penetrating trauma patients who were resuscitated with low volume HES.

UR - http://www.scopus.com/inward/record.url?scp=84979066470&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84979066470&partnerID=8YFLogxK

U2 - 10.7205/MILMED-D-15-00132

DO - 10.7205/MILMED-D-15-00132

M3 - Article

C2 - 27168566

AN - SCOPUS:84979066470

VL - 181

SP - 152

EP - 155

JO - Military Medicine

JF - Military Medicine

SN - 0026-4075

IS - 5

ER -