The CRISTAL trial compared crystalloids versus colloids for ICU resuscitation. The main finding was:
- A Colloids improved haemodynamic parameters but both had equivalent 28-day mortality; colloids reduced 90-day mortality ✓
- B Colloids significantly reduced 28-day mortality
- C Crystalloids were superior in all outcomes
- D Hydroxyethyl starch colloids increased AKI risk — trial stopped early
Correct answer: A. Colloids improved haemodynamic parameters but both had equivalent 28-day mortality; colloids reduced 90-day mortality
Explanation
The CRISTAL trial (2013) found no significant difference in 28-day mortality between colloids and crystalloids for ICU resuscitation of hypovolaemic shock; however, a secondary endpoint showed colloids reduced 90-day mortality. Colloid patients required less fluid volume and had shorter time on vasopressors. The CHEST trial separately showed HES (hydroxyethyl starch) increased acute kidney injury and RRT requirements — HES is now contraindicated in ICU. CRISTAL used heterogeneous colloids, limiting conclusions.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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