Cochrane · systematic review · CD000567
Colloids versus crystalloids for fluid resuscitation in critically ill people
Lewis, SR, Pritchard, MW, Evans, DJW, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
InjuriesAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
23
current version
GRADE rated
20
No studies
3
Included studies
NR
No studies 3 · 13%Ungraded 0 · 0%Very low 6 · 26.1%Low 4 · 17.4%Moderate 10 · 43.5%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Starches compared to crystalloid for fluid resuscitation in critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (at end of Starches vs crystalloid | RR 0.97 [0.86, 1.09] | 24 studies · 11177 participants | Moderate Downgraded: risk of bias |
All‐cause mortality (at 90 days) Starches vs crystalloid | RR 1.01 [0.9, 1.14] | 15 studies · 10415 participants | Moderate Downgraded: risk of bias |
All‐cause mortality (within 30 days) Starches vs crystalloid | RR 0.99 [0.9, 1.09] | 11 studies · 10135 participants | Moderate Downgraded: risk of bias |
Transfusion of blood products Starches vs crystalloid | RR 1.19 [1.02, 1.39] | 8 studies · 1917 participants | Moderate Downgraded: risk of bias |
Renal replacement therapy Starches vs crystalloid | RR 1.3 [1.14, 1.48] | 9 studies · 8527 participants | Moderate Downgraded: risk of bias |
Adverse events Starches vs crystalloid | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Dextrans compared to crystalloid for fluid resuscitation in critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (at end of Dextrans vs crystalloid | RR 0.99 [0.88, 1.11] | 19 studies · 4736 participants | Moderate Downgraded: risk of bias |
All‐cause mortality (within 90 days and within 30 days) Dextrans vs crystalloid | RR 0.99 [0.87, 1.12] | 10 studies · 3353 participants | Moderate Downgraded: risk of bias |
Transfusion of blood products Dextrans vs crystalloid | RR 0.92 [0.77, 1.1] | 3 studies · 1272 participants | Very low Downgraded: risk of bias, imprecision |
Renal replacement therapy Dextrans vs crystalloid | no estimate extracted | NR | No studies |
Adverse events Dextrans vs crystalloid | no estimate extracted | NR | No studies |
Gelatins compared to crystalloid for fluid resuscitation in critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (at end of Gelatins vs crystalloid | RR 0.89 [0.74, 1.08] | 6 studies · 1698 participants | Low Downgraded: risk of bias, imprecision |
All‐cause mortality (within 90 days) Gelatins vs crystalloid | RR 0.89 [0.73, 1.09] | 1 study · 1388 participants | Low Downgraded: imprecision |
All‐cause mortality (within 30 days) Gelatins vs crystalloid | RR 0.92 [0.74, 1.16] | 1 study · 1388 participants | Low Downgraded: imprecision |
Transfusion of blood products Gelatins vs crystalloid | RR 5.89 [0.24, 142.41] | 1 study · 167 participants | Very low Downgraded: risk of bias, imprecision |
Renal replacement therapy Gelatins vs crystalloid | no estimate extracted | NR | No studies |
Adverse events Gelatins vs crystalloid | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Albumin and fresh frozen plasma compared to crystalloid for fluid resuscitation in critically ill patients
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality (at end of Albumin and fresh frozen plasma vs crystalloid | RR 0.98 [0.92, 1.06] | 20 studies · 13047 participants | Moderate Downgraded: risk of bias |
All‐cause mortality (within 90 days) Albumin and fresh frozen plasma vs crystalloid | RR 0.98 [0.92, 1.04] | 10 studies · 12492 participants | Moderate Downgraded: risk of bias |
All‐cause mortality (within 30 days) Albumin and fresh frozen plasma vs crystalloid | RR 0.99 [0.93, 1.06] | 10 studies · 12506 participants | Moderate Downgraded: risk of bias |
Transfusion of blood products Albumin and fresh frozen plasma vs crystalloid | RR 1.31 [0.95, 1.8] | 3 studies · 290 participants | Very low Downgraded: risk of bias, imprecision |
Renal replacement therapy Albumin and fresh frozen plasma vs crystalloid | RR 1.11 [0.96, 1.27] | 2 studies · 3028 participants | Low Downgraded: risk of bias |
Adverse events Albumin and fresh frozen plasma vs crystalloid | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |