Is double-blinding possible while administering fluids in the intensive care unit?

摘要

The publication by Alavi SM et al. highlights a subject with an ongoing debate, namely the 'crsytalloid-colloid and colloid-colloid use following cardiac surgery'.1 They designed a randomised, double-blind clinical trial and compared the effects of three different solutions; 0.9% Ringer's lactate, 4% gelatin and 6% hydroxyethyl starch (HES) solution. They concluded that the HES solution was better in terms of the volume-expanding effect; lower amounts were required compared to the other two solutions, and short-term renal functions were better. We feel that there are several insufficiencies about the design and contents of the study. We believe that the process of double-blinding is quite challenging in this study, because the anesthesiologist or intensivist should be unaware of the solution administered. The process of double-blinding and how un-blinding was avoided should be detailed.