Colloids versus crystalloids as priming solutions for cardiopulmonary bypass: a meta-analysis of prospective, randomised clinical trials.

摘要: Using Cochrane methodology a review was performed of prospective randomized clinical trials comparing colloidal pump priming solutions for cardiopulmonary bypass. Dextrans were not considered. Database searches from 1966 through December 2002 delivered 265 articles. Seventeen studies finally met the eligibility criteria involving 997 patients. Summary odds ratio estimates 5 reporting mortality 1.46 (n = 326; 95%-Confidence-Interval: .55 to 3.85; p .49) crystalloids against colloids and .74 150; .17 3.36; albumin versus synthetic colloids. Most commonly used outcome measures further included postoperative blood loss, platelet-count, fluid-balance and, colloid osmotic pressures which Standardized Mean Differences (SMD) their 95%-Confidence-Interval (95%CI) extracted. Colloids produced significantly higher oncotic less positive fluid-balances. Although across 9 bleeding between did differ 663; SMD: -.03, 95%CI: -.18 .12; .69), platelet counts favoured 465; -.42; -.68 -.16; .00). However, compared disfavoured only by starches 321; -.55; -.77 -.32; To conclude, using mere more pronounced fluid balances avoidance as single pump-prime component can be suggested. Since is necessarily associated with better outcomes expensive, it hard continue its use. there still insufficient evidence available allow definitive conclusions.