The great fluid debate- methodology, physiology and appendicitis

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Hans-Joachim Priebe, Manu L.N.G. Malbrain, Paul Elbers


In light of the fifth annual International Fluid Academy Days (IFAD) meeting in Antwerp, Belgium, it is time to stand still and reflect on the years that have passed since the first IFAD meeting and the publication of the major fluid trials in high profile journals. While these produced partly conflicting results, some contained signals of increased mortality and higher incidence of renal replacement therapy associated with the administration of hydroxyethyl starch (HES). This led to warnings by regulatory bodies and virtually imposed a clinical ban on artificial colloids. Incidentally, this also triggered the great fluid debate and arguably fueled the success of IFAD.

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