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A committee of the European Medicines Agency has called for a suspension of the marketing of infusible hydroxyethyl starch (HES), concluding that the clinical benefits of the products “no longer outweigh their risks.”
Infusion solutions containing HES are medicines mainly used to replace lost blood volume in hypovolaemia (low blood volume caused by dehydration or blood loss) and hypovolaemic shock (a steep fall in blood pressure caused by drop in blood volume). They are used in critically ill patients including patients with sepsis (bacterial infection of the blood) or burn or trauma injuries, or patients who are undergoing surgery.
Fluid therapy is a routine part of intraoperative anesthetic and surgical practice, and there is increasing evidence that fluid therapy can affect perioperative outcomes. This article focuses on methods of goal directed therapy, and how to clinically assess & monitor perioperative blood volume.
Perioperative Medicine 2013, 2:9
A bedside test for raised intracranial pressure?
A recent study in Intensive Care Medicine confirmed that ultrasonography of the optic nerve sheath diameter is a good way to detect raised intracranial pressure. (2011;37:1059.) That meta-analysis by Julie Dubourg, MD, and her colleagues of Hospices Civils de Lyon, Université Claude Bernard Lyon in France, pooled six studies, a total of 231 patients, and compared ultrasonography with intracranial pressure monitoring. They concluded that a positive test was associated with a 51 times higher risk of intracranial hypertension.