Key result
Hydroxyethyl starch (HES) use is associated with concerns regarding nephrotoxic effects, increased bleeding risk, and higher mortality, though further large-scale trials are indicated.
Despite safety concerns regarding nephrotoxicity and bleeding, further large-scale trials are required before completely discarding hydroxyethyl starch for fluid management.
Hydroxyethyl starch (HES) family has been one of the cornerstones in fluid management for over four decades. Recent evidence from clinical studies and meta-analyses has raised few concerns about the safety of these fluids, especially in certain subpopulations of patients. High-quality clinical trials and meta-analyses have emphasized nephrotoxic effects, increased risk of bleeding, and a trend toward higher mortality in these patients after the use of HES solutions. Scientific evidence was derived from international guidelines, aggregated research literature, and opinion-based evidence was obtained from surveys and other activities (e.g., internet postings). On critical analysis of the current data available, it can be summarized that further large scale trials are still indicated before HES can be discarded.
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Datta et al. (2014) conducted a review in Fluid management. Hydroxyethyl starch (HES) was evaluated. Hydroxyethyl starch (HES) use is associated with concerns regarding nephrotoxic effects, increased bleeding risk, and higher mortality, though further large-scale trials are indicated.
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