Re-evaluating currently available data and suggestions for planning randomised controlled studies regarding the use of hydroxyethyl starch in critically ill patients - a multidisciplinary statement

Meybohm, P. (Patrick)
Aken, H. (Hugo) van
Gasperi, A.D. (Andrea)
Hert, S. (Stefan) de
Rocca, G.D. (Giorgio)
Girbes, A.R.J. (Armand)
Gombotz, H. (Hans)
Guidet, B. (Bertrand)
Hasibeder, W. (Walter)
Hollmann, M.W. (Markus)
Ince, C. (Can)
Jacob, M. (Matthias)
Kranke, P. (Peter)
Kozek-Langenecker, S. (Sybille)
Loer, S.A. (S.)
Martin, C. (Claude)
Siegemund, M. (Martin)
Wunder, D. (Dorothea)
Zacharowski, K. (Kai)

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Publication date

July 2013

DOI

10.1186/cc12845

Publisher

Springer Science and Business Media LLC

Abstract

Introduction: Hydroxyethyl starch (HES) is a commonly used colloid in critically ill patients. However, its safety has been questioned in recent studies and meta-analyses. Methods: We re-evaluated prospective randomised controlled trials (RCT) from four meta-analyses published in 2013 that compared the effect of HES with crystalloids in critically ill patients, focusing on the adherence to 'presumably correct indication'. Regarding the definition of 'presumably correct indication', studies were checked for the following six criteria (maximum six points): short time interval from shock to randomisation (<6 h), restricted use for initial volume resuscitation, use of any consistent algorithm for haemodynamic stabilisation, reproducible indicat...