الفهرس 
Introduction and of aim of workOnly 14 pages are availabe for public view
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Abstract
BACKGROUND Although previous studies have suggested the potential advantages and disadvantages of albumin and hydroxyethylstarch 6%;130/0.4 administration in patients with severe sepsis, their potential survival benefits and hazards on organ functions have not been fully established and still a standing issue of debate of debate .
METHODS In this Prospective randomized controlled comparative study, we randomly assigned 165 patients with severe Sepsis and septic shock, in Ain Shams University Hospital’s intensive care units (ICUs), to receive either 4% albumin or HES 6% 130/0.4 or saline 0.9% alone. The groups were followed till discharge from the ICU or death or 28 days after randomization. The primary outcome was death from any cause at 28 days. Secondary outcomes were new organ failures for cardiovascular, respiratory, coagulation, and liver systems that were not present at baseline were defined by a score of 3 or more on the Sequential Organ Failure Assessment (SOFA), use of hemodynamic support, renal replacement therapy, mechanical ventilation and length of stay in the ICU.
RESULTS In Our study mortailty at 28 days was 18 of 55 patients (32.72 % ) in albumin group vs 21of 55(38.1%) in saline group vs 22 of 55 in HES group( 40%) ,the study fail to prove any significant difference between the three groups, p value ( 0.713).
There was a trend towards increase in renal replacement therapy in HES 6% group (41.8%) yet not statistically significant with p value (0.478).
There was no statistically significant difference in rate of haemodynamic support use or mechanical ventilation. The use of colloids was associated with less total volume of 6%HES (m= 9.5) L or 4% albumin (m =9 L) infused than saline (m=12.6) .The length of stay in ICU was longer with 6%HES (m=8 days) in coparison with albumin and saline (m=7days).
CONCLUSION there is no statistically significant difference in mortality with the use of HES 6%130-0.4 vs. 0.9% normal saline vs albumin 4% in the resuscitation of severe sepsis patients; with trend towards lower mortality in albumin group and trend to higher rate of renal replacement therapy and statistically significant increase in length of stay in the ICU in HES 6% group .
Key words: sepsis fluid resuscitation mortality .
References
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