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Comparing the effect of hydroxyethyl starch 130/0.4 with balanced crystalloid solution on mortality and kidney failure in patients with severe sepsis (6S--Scandinavian Starch for Severe Sepsis/Septic Shock trial): study protocol, design and rationale for a double-blinded, randomised clinical trial.

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Authors
Perner, Anders
Haase, Nicolai
Wetterslev, Jørn
Aneman, Anders
Tenhunen, Jyrki
Guttormsen, Anne Berit
Klemenzson, Gudmundur
Pott, Frank
Bødker, Karen Doris
Bådstøløkken, Per Martin
Bendtsen, Asger
Søe-Jensen, Peter
Tousi, Hamid
Bestle, Morten
Pawlowicz, Malgorzata
Winding, Robert
Bülow, Hans-Henrik
Kancir, Claude
Steensen, Morten
Nielsen, Jonas
Fogh, Bjarne
Madsen, Kristian R
Larsen, Nils H
Carlsson, Marcela
Wiis, Jørgen
Petersen, John Asger
Iversen, Susanne
Schøidt, Ole
Leivdal, Siv
Berezowicz, Pawel
Pettilä, Ville
Ruokonen, Esko
Klepstad, Pål
Karlsson, Sari
Kaukonen, Maija
Rutanen, Juha
Karason, Sigurbergur
Kjældgaard, Anne Lene
Holst, Lars Broksø
Wernerman, Jan
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Issue Date
2011

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Citation
Trials 2011, 12(1):24
Abstract
BACKGROUND: By tradition colloid solutions have been used to obtain fast circulatory stabilisation in shock, but high molecular weight hydroxyethyl starch (HES) may cause acute kidney failure in patients with severe sepsis. Now lower molecular weight HES 130/0.4 is the preferred colloid in Scandinavian intensive care units (ICUs) and 1st choice fluid for patients with severe sepsis. However, HES 130/0.4 is largely unstudied in patients with severe sepsis. METHODS/DESIGN: The 6S trial will randomize 800 patients with severe sepsis in 30 Scandinavian ICUs to masked fluid resuscitation using either 6% HES 130/0.4 in Ringer's acetate or Ringer's acetate alone. The composite endpoint of 90-day mortality or end-stage kidney failure is the primary outcome measure. The secondary outcome measures are severe bleeding or allergic reactions, organ failure, acute kidney failure, days alive without renal replacement therapy or ventilator support and 28-day and 1/2- and one-year mortality. The sample size will allow the detection of a 10% absolute difference between the two groups in the composite endpoint with a power of 80%. DISCUSSION: The 6S trial will provide important safety and efficacy data on the use of HES 130/0.4 in patients with severe sepsis. The effects on mortality, dialysis-dependency, time on ventilator, bleeding and markers of resuscitation, metabolism, kidney failure, and coagulation will be assessed.
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http://dx.doi.org/10.1186/1745-6215-12-24
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3040153/?tool=pubmed
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ae974a485f413a2113503eed53cd6c53
10.1186/1745-6215-12-24
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