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Network meta-analysis of clinical trials of fluid treatments in sepsis demonstrates improved survival with albumin compared with crystalloid and hydroxyethyl starch
Critical Care volume 17, Article number: P375 (2013)
Fluid resuscitation is widely practiced in treating sepsis. Comparative assessment of the different fluid modalities is hampered by a paucity of direct trials. We present a network meta-analysis for assessing the relative effectiveness of two fluid treatments in sepsis when they have not been compared directly in a randomized trial but have each been compared with a common treatment.
A systematic review of trials sepsis yielded 13 trials for assessment in network meta-analysis. The indirect comparison between albumin, HES and crystalloid was conducted using Bayesian methods for binomial likelihood, fixed-effects network meta-analysis with a Monte Carlo Gibbs sampling method. Studies in septic patients with crystalloid as a reference treatment compared with any formulation of the colloid treatments albumin or HES were included, as were direct head-to-head trials between the two colloids.
Albumin as a fluid therapy in sepsis is associated with the lowest mortality of the three modalities studied.
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Bansal, M., Farrugia, A. & Martin, G. Network meta-analysis of clinical trials of fluid treatments in sepsis demonstrates improved survival with albumin compared with crystalloid and hydroxyethyl starch. Crit Care 17, P375 (2013). https://doi.org/10.1186/cc12313
- Septic Patient
- Gibbs Sampling
- Fluid Resuscitation