Impact of Colloid Infusion on Outcomes in Patients with Septic Shock

Background: Although colloid solution has been widely used in practice, its impact on mortality in patients with septic shock remains unknown. We evaluated the association of colloid infusion with outcomes in septic shock patients.Methods: Medical Information Mart for Intensive Care (MIMIC)-III was used to identify patients with septic shock. Propensity score matching (PSM) was employed to balance the baseline differences. Cox proportional hazards model, Wilcoxon rank-sum test, and logistic regression were utilized to determine the associations of colloid infusion with mortality, length of stay, and recovery of kidney function, respectively.Results: A total of 4,553 septic shock patients were studied, including 1,158 with colloid infusion, and 3,395 without colloid infusion. After PSM, 1,012 pairs of patients were matched. Significant benefits in the mortality rate were observed in the colloid group compared with the non-colloid group, with the 28-day mortality [hazard ratio (HR) 0.62; 95% confidence interval [CI], 0.52-0.73; P < 0.001], and the 90-day mortality [HR 0.76; 95% CI 0.65-0.88; P < 0.001]. Colloid infusion was not associated with the renal function recovery [HR 1.06; 95% CI 0.87–1.29; P = 0.547] in either population. Nevertheless, subgroup analysis revealed that colloid infusion did not affect the 28-day mortality in people with sepsis of AKI stage 1. In addition, the use of dextran did not decrease the 28-day mortality (HR 1.41; 95% CI 0.19-10.59; P = 0.736). Conclusion: In septic shock patients, colloid infusion (albumin or hydroxyethyl starch) improved short-term survival, but had no clear effect on the recovery of renal function.