The Safety Of Hydroxyethyl Starch Versus Crystalloid Solution For Non-septic Patients In The Intensive Care Unit:A Meta-analysis

Objective:Hydroxyethyl starch has been worn by the European pharmacovigilance assessment committee and the FDA for its possibility of increasing the mortality and renal replacement therapy on septic patients.However,the role of hydroxyethyl starch on non-septic patients is still unknown.This study was to detect the effectiveness and adverse reaction of hydroxyethyl starch versus crystalloid solution for non-septic patients in the intensive care unit.Methods:We generated a retrieval strategy based on the inclusive and exclusion criteria of the original literature,then retrieve the English database MEDLINE?EMBASE?Cochrane library?Ovid and the Chinese database CNKI?WANFANG and VIP for the RCT on non-septic patients treated with Hydroxyethyl starch in the intensive care unit,data by 2016.5.31.Two senators discuss the quality of the inclusive-literatures and extract data independently.Data were analyzed by Review Manager 5.2 software.Results:We searched 2312 literatures and screened out 12 original literatures for this meta-analysis.Results showed that compared with other crystalloid solution,Hydroxyethyl starch treatment did not increase the overall mortality(RR1.06,95%CI 0.92~1.21;I2=0%,P=0.90)and the implement of renal replacement therapy(RR=1.14,95%CI 0.55-2.35,I2=0%,P=0.89),it also did not extend ICU stays(I2=0%?P=0.88;MD=0.04,95%CI-0.2~0.28)and the total hospital stays(I2=0%?P=0.9;MD=-0.01,95%CI-0.41~0.39).The bleeding volume was not increased(P=0.31,I2=17%,MD=20.5,95%CI-41.27~82.27),as well as the amount of RBC infusion(P=0.68,I2=0%,MD=-0.31,95%CI-0.71~0.08)for Hydroxyethyl starch treatment.We also found that,the first day liquid volume needed for ICU patients was markedly reduced in Hydroxyethyl starch group than that of crystalloid solution group(SMD=-0.58,95%CI-0.88~-0.28,I2=39%,P=0.18).Conclusion:This meta-analysis discovered that Hydroxyethyl starch did not increase mortality?implement of renal replacement therapy ?bleeding volume and the amount of RBC infusion,and it also did not extend ICU stays and the total hospital stays for non-septic patients in ICU.However,there also exists some defects,such as the small sample and poor quality of study.