In this edition of the series, Dr. Molinar provides an excellent review of the different types of hetastarches available along with associated pharmacokinetic and pharmacodynamic profiles.
CLICK HERE TO VIEW THE RECORDED JOURNAL CLUB WEBINAR
This is followed by Dr. Ahn’s review and discussion of the Schortgen et al. study in Lancet 2001. This was thew first “larger” study to evaluate hetastarch and its possible deleterious effect on the kidneys when compared to Gelatin in a multi-center randomized trial in France.
Finally, not until 2008 did we have a large multi-center German study called the VISEP trial published in NEJM which looked at severe sepsis and septic shock patients and compared Hetastarch to Lactated ringers (along with evaluation of intensive vs conventional glucose control). This too as a secondary endpoint ealuated the effects of therapy on renal failure and need for RRT. Although this trial was stopped prematurely because of severe hypoglycemic episodes in the intensive insulin therapy group, it is still the single largest multicenter trial to date looking at the outcomes of septic patients receiving Hetastarch.
These two trials really are the basis of what I have termed the “anti-hextend” movement in the critical care community however they are marked by a myriad of SIGNIFICANT design and statistical FLAWS which have also led to widespread criticism. This journal club webinar aims to dig deep into the analysis of these two trials and was a very engaging and though provoking session. Please FEEL free to comment below and let the discussion continue!!
In keeping with the spirit of ICU 2.0-3.0, I am proud to announce the introduction of the Critical Care Journal Club Series. The series will feature weekly or bi-weekly online, live, real time broadcasts of journal club conferences in the Surgical Intensive Care. The presenters will be residents and fellows rotating through the Surgical ICU and will be moderated by an attending physician. These discussions, much like the anesthesia ones are lively, educational and usually lead to animated conversations on controversial critical care topics facing us today.
Subscribe to the site via twitter or rss to get regular updates and find out how you can attend the next session LIVE online. In the mean time:
CLICK HERE
to get to the list of recordings of the sessions. As always, comments, suggestions and lively discussion is heavily encouraged!!
Now featuring live online journal clubs on exciting topics in Anesthesia primarily focused on the ambulatory setting. Follow the link to the Journal Club Series to explore the site and register for the next event. Theses live journal clubs are moderated, live events that lead to lively discussions and feature some of the experts in the field. After the event, you can find a link to the recording of the event where you can review the conference and continue the conversation online …. click on the link and enjoy …
It really starts with you. As taboo as the topic may be, its a must for every individual to think about this and most importantly discuss it with the ones you love most. This is the most effective way to ensure that your wishes are truly upheld.
Here’s a great tool available online – The One Slide Project
Here is a link to the US Living Will Registry where you can find out more specific information. The link takes you directly to the state specific forms.
I apologize for the long delay between posts but I have been working on getting some updates into the website. As you can see, our theme is entirely different and starting today – We are iPhone friendly! 
now you can visit anytime and have the same ease of use that you do from the computer at home or work. Enjoy!
