Van der Heijden 2009.

Methods	RCT Parallel design Single centre
Participants	Total number of randomised participants: 48 Inclusion criteria: mechanically ventilated and critically ill people with clinical hypovolaemia and at risk for, or with, ALI/ARDS Exclusion criteria: > 78 years of age; pregnant; known anaphylactoid reaction to colloid fluids; life expectancy < 24 h Participant condition: clinical hypovolaemia Baseline characteristics Colloids group (HES) Age, median (range): 57 (22‐75) years Gender, M:F: 9:3 APACHE II, median (range): 12 (6‐23) Colloids group (albumin) Age, median (range): 61 (39‐77) years Gender, M:F: 8:4 APACHE II, median (range): 15 (5‐18) Colloids group (gelatin) Age, median (range): 61 (27‐74) years Gender, M:F: 9:3 APACHE II, median (range): 10 (4‐20) Crystalloids group Age, median (range): 62 (25‐77) years Gender, M:F: 9:3 APACHE II, median (range): 10 (6‐23) Country: the Netherlands Setting: hospital
Interventions	Colloids group (HES) Participants: n = 12; losses = 0; analysed = 12 Details: 6% HES 200/0.45‐0.55 Additional details: fluids given during 90 min on basis of response to predefined pressure limits and CVP, according to a protocol; boluses at maximum of 200 mL/10 min, so that maximum fluid challenge was 1800 mL in 90 min Colloids group (albumin) Participants: n = 12; losses = 0; analysed = 12 Details: albumin 5%; 100 mL Cealb 20%; diluted in 300 mL of saline Additional details: same as colloids group (HES) Colloids group (gelatin) Participants: n = 12; losses = 0; analysed = 12 Details: 4% Gelofusine 40 g/L; in 154/120 mM NaCl Additional details: same as colloids group (HES) Crystalloids group Participants: n = 12; losses = 0; analysed = 12 Details: 0.9% (assume NS) Additional details: same as colloids group (HES)
Outcomes	Outcomes measured/reported: haemodynamic variables; respiratory variables; mortality Outcomes relevant to the review: mortality (until discharge from the ICU)
Notes	Funding/declarations of interest: supported in part by B Braun Medical, Melsungen, Germany and the Netherlands Heart Foundation, The Hague Study dates: not reported Patients stratified into septic and non‐septic. We combined these groups. Use of online supplementary information for some data
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomisation performed by pharmacist; no additional detail on methods used to generate codes
Allocation concealment (selection bias)	Low risk	Used sealed envelopes prepared by pharmacist
Blinding of participants and personnel (performance bias): mortality	Low risk	No details of blinding; unlikely to introduce bias for mortality
Blinding of outcome assessment (detection bias): mortality	Low risk	No details of blinding; unlikely to introduce bias for mortality
Incomplete outcome data (attrition bias) All outcomes	Low risk	No apparent losses
Selective reporting (reporting bias)	Unclear risk	No details of clinical trials registration or prepublished protocol; not feasible to assess risk of selective outcome reporting bias
Baseline characteristics	Low risk	Baseline characteristics appeared comparable
Other bias	Low risk	No other sources of bias identified