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Changes in colloid solution sales in Nordic countries

Kongsgaard UE, Holtan A, Perner A
4 December, 2019  

Despite the wide range of options for resuscitation fluids in intensive care, an optimal fluid therapy has not been established, as new evidence accumulates, and treatment guidelines are revised accordingly.

These guidelines can differ substantially from region to region.

In the Nordic countries, the use of crystalloids is recommended, but administration of synthetic colloid hydroxylethyl starch (HES) is discouraged owing to its detrimental side effects in critically ill patients.

This study sought to determine if these recommendations are being homogeneously translated into clinical practice in five Scandinavian countries by analysing sales data provided by the manufacturers of resuscitation fluids.

From 2012 to 2016, the total sales of colloids decreased by 56%, which can largely be explained by a reduction of 92% in the sales of HES. Although not significant, a decrease was also observed for other synthetic colloids such as dextran and gelatine solutions. By contrast, there was an increase of 46% in the sales of albumin products. This increase was highly variable across the countries included in the study, with Finland showing the largest increase (127%) and Norway the lowest (21%).

Overall, these patterns of use of colloids reflect the current guidelines for fluid resuscitation in this region.