title: Hydroxyeyhyl starch: Controversies revisited.
abstract: 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.
authors.affiliation: Department of Anaesthesiology & Critical Care, Army Hospital (R & R), Delhi Cantonment, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Datta
authors.affiliation: Department of Anaesthesiology & Critical Care, Army Hospital (R & R), Delhi Cantonment, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Nair
authors.affiliation: Department of Anaesthesiology & Critical Care, Army Hospital (R & R), Delhi Cantonment, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Pandey
authors.affiliation: Department of Anaesthesiology & Critical Care, Army Hospital (R & R), Delhi Cantonment, India.
authors.forename: Nitish
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesiology & Critical Care, Army Hospital (R & R), Delhi Cantonment, India.
authors.forename: Tapan
authors.initials: T
authors.lastname: Sahoo
keywords: Controversies; colloids; hydroxyethyl starch