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Online ISSN 1827-1596
Trof R. J. 1, Groeneveld A. B. J. 2
1 Department of Intensive Care, Medisch Spectrum Twente, Enschede, The Netherlands;
2 Department of Intensive Care, VU Medical Centre, Amsterdam, The Netherlands
In this narrative review, the studies and analyses are discussed that pertain to benefits and detriments of synthetic colloids versus natural colloids or crystalloids used for fluid resuscitation in sepsis and septic shock. The relative amount of fluid infusions used to reach clinical or hemodynamic end-points are reviewed, as well as potential toxicity of starch solutions on the kidney. Hence, it cannot be excluded that adverse effects partly offset beneficial hemodynamic effects that are similar to that of natural colloids, so that in most analyses a mortality benefit of synthetic colloid fluid resuscitation in sepsis and septic shock cannot be demonstrated.