Key result
Hydroxyethyl starch solutions continue to have a place in perioperative fluid management when used for proper indications and at recommended doses, despite recent recommendations to ban them.
Why the study?
Does the use of hydroxyethyl starch (HES) solutions compared to crystalloids worsen outcomes in critically ill and surgical patients?
Does the use of hydroxyethyl starch (HES) solutions compared to crystalloids worsen outcomes in critically ill and surgical patients?
This review argues against the EMA ban on hydroxyethyl starch solutions, highlighting methodological flaws in the trials that prompted the ban and supporting the continued use of HES for specific perioperative indications.
This review summarises the new insights into the physiology of perioperative fluid therapy and analyses recent studies of the safety of the use of HES solutions in the fluid management of critically ill patients. This analysis reveals a number of methodological issues in the three major studies that have initiated the recommendation of the European Medicine Agency to ban hydroxyethyl starches from clinical practice. It is concluded that, when used in the proper indication, and taking into account the recommended doses, hydroxyethyl starches continue to have a place in perioperative fluid management.
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Hert et al. (2014) conducted a review in Perioperative fluid management and critical illness. Hydroxyethyl starch (HES) solutions vs. Crystalloids was evaluated. Hydroxyethyl starch solutions continue to have a place in perioperative fluid management when used for proper indications and at recommended doses, despite recent recommendations to ban them.
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