“a retrospective ecological study examining regional and temporal trends in IV fluid consumption across Australia and New Zealand over the periods 2012-2013 and 2013- 2014, using national proprietary sales data as a surrogate for consumption, and demographic data from the public domain.”
What an inspired study design and what heartening findings. Best news I’ve had since Team GB athletes trounced the rest of the world in Rio.
Table 1 makes for interesting comparisons. For instance, HES was ahead of MFG 3-2 in NZ in 12/13, while MFG was leading 2-1 in Aus. ACT/NSW was the only Aus state preferring HES. The collapse in HES sales in 13/14 was not offset by a swing to MFG, and albumin sales (20%, 4%) showed only a small increase. The HES sales team never seem to have reached NT! Well done NT. Probably has Aus/NZ best sepsis survival rate!
“given the modern understanding of microvascular fluid dynamics, the intravascular persistence of colloids is likely to be limited. It is also possible that fluid resuscitation itself may disrupt the glycocalyx, further altering the transvascular equilibrium in states of acute illness. Clinical evidence has shown that replacement of colloids with crystalloids occurs with a 1:1.3 ratio instead of the 1:3 ratio that has been postulated by advocates of the traditional Starling hypothesis.”
You read it here
first. Though I have to admit the resilience of MFG sales tells me these shifts are anti-HES rather than steady-state Starling Enlightenment. My work is not yet done here.
Every national ICM/CCM College/ Society should be sponsoring or commissioning such studies over the next decade. When biophysical osmotic plasma subs use has dwindled to the point where the producers withdraw from the market I can shut down the laptop and go fishing. New Zealand, of course. Sorry Aussie friends, but our English trout have grown so much bigger there.
Changes in intravenous fluid use patterns in Australia and New Zealand: Evidence of research translating into practice. Available from: https://www.researchgate.net/publication/305293840_Changes_in_intravenous_fluid_use_patterns_in_Australia_and_New_Zealand_Evidence_of_research_translating_into_practice [accessed Aug 25, 2016].