tailieunhanh - Báo cáo y học: "10% Hydroxyethylstarch impairs renal function and induces interstitial proliferation, macrophage infiltration and tubular damage"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: 10% Hydroxyethylstarch impairs renal function and induces interstitial proliferation, macrophage infiltration and tubular damage. | Available online http content 13 4 413 Letter 10 Hydroxyethylstarch impairs renal function and induces interstitial proliferation macrophage infiltration and tubular damage Martin Siegemund Department of Anaesthesia and Intensive Care Medicine Surgical ICU University Hospital Basel Surgical ICU Spitalstrasse 21 CH-4031 Basel Switzerland Corresponding author Martin Siegemund siegemundm@ Published 8 July 2009 This article is online at http content 13 4 413 2009 BioMed Central Ltd Critical Care 2009 13 413 doi cc7928 See related research by Huter et al. http content 13 1 R23 Huter and colleagues recently published an experimental paper about possible pathomechanisms of hydroxyethylstarch HES -induced adverse effects on renal function in an isolated perfusion model of 6 hours 1 . The authors should be congratulated for their attempt to shed light on the influence of different HES preparations on renal function combining functional results and histological data. In the recently published prospective randomized controlled Efficacy of Volume Substitution and Insulin Therapy in Severe Sepsis VISEP trial 10 HES 200 05 caused a close to significant increase in 90-day mortality in septic patients. Renal failure and renal replacement therapy significantly increased dose dependently compared with Ringer s lactate treatment. Unfortunately 100 out of 262 patients in the HES group received more than the maximum allowed daily dose on at least 1 day the majority occurring on the first day after study inclusion. The patients without a violation of the maximum daily dose administration had a mortality rate even lower than that in the Ringer s lactate group 2 . In their isolated renal perfusion model Huter and colleagues tried to answer some of the questions originating from the VISEP trial comparing 10 HES 200 6 HES 130 and Ringer s lactate 1 . The hyperoncotic 10 HES used in the VISEP study showed severe oliguria impaired .