The pointlessness of starch to boost oxygen delivery in surgical patients…

Reiterer C, Kabon B, Zotti O, Obradovic M, Kurz A, Fleischmann E. Effect of goal-directed crystalloid- versus colloid-based fluid strategy on tissue oxygen tension: a randomised controlled trial. Br J Anaesth. 2019;123:768-776.


Yet another HES vs LR for GDT in major surgery RCT. Regular readers will understand that modern Starling fluid physiology leads us to understand that the colloid:crystalloid volume equivalence for stroke-volume directed administration is about 1:1.5. In this study it was 1:1.27. Readers will also know that I get boring when having to point out yet again that if you dilute blood oxygen carrying capacity with non-sanguineous fluid you can’t seriously expect that oxygen delivery to the tissues will rise. In this study, tissue oxygen tension is not improved by GDT. Aren’t we just wasting the good will of patient participants and cutting down unnecessary trees for this sort of “confirming the confirmatory study of what physiology predicts” experiment? Clinical anaesthesia needs research that has a chance of showing a better way to do things if it is not to get stuck on NeverEnding Fluid comparisons.

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