什么患者不应使用羟乙基淀粉？

What patients should avoid using the hydroxyethyl starch？

背景羟乙基淀粉对患者肾功能、凝血功能的不良影响和在危重患者预后方面的不良作用令人关注。目的就羟乙基淀粉在危重患者使用的新进展进行综述。内容基于近期的文献报道，分别探讨羟乙基淀粉对脓毒症、创伤、颅脑损伤、烧伤、心脏手术、器官移植手术、小儿、急性重症胰腺炎等危重患者的。肾功能、凝血功能和病死率的影响。趋向羟乙基淀粉对脓毒症、顿挫性创伤、CPB下心脏手术和器官移植患者的预后有不良影响。羟乙基淀粉可改善急性重症胰腺炎患者的早期预后。在颅内创伤、烧伤、小儿患者中羟乙基淀粉的安全性问题仍然值得进一步探讨。

Background The adverse effects of hydroxyethyl starch on renal function, coagulation and outcome of critically ill patients are a great concern of clinicians. Objective To review the recent progress of the use of hydroxyethyl starch in critically ill patients. Content Based on literatures published in recent years, we discussed the effects of hydroxyethyl starch on renal function, coagulation and mortality in patients, including pediatric patients, with sepsis, acute severe pancreatitis, trauma, traumatic brain injury and burns, in patients undergoing cardiac surgery and organ transplantation. Trend Use of hydroxyethyl starch has harmful effects on prognosis in patient with sepsis and blunt trauma, as well as in patients undergoing cardiac surgery under cardiopulmonary bypass and organ transplantation. Use of hydroxyethyl starch may improve the prognosis in patients with acute severe pancreatitis, in patients with traumatic brain injury and burns, as well as in pediatric patients, the safety of hydroxyethyl starch is worth of further demonstration.