METHODS:
We first conducted a blinded, clinical trial, in which we randomly assigned patients with severe sepsis in the intensive care unit to fluid resuscitation with either 6% HES 130/0.42 (Tetraspan) or Ringer's acetate. The primary outcome measure was death or dialysis-dependency at 90 days after randomisation. Secondary outcomes described kidney function and serious adverse reactions. Secondly, we systematically identified all randomised clinical trials comparing tetrastarch with either crystalloid or albumin in patients with sepsis and pooled their results in meta-analyses and trial sequential analyses