Erschienen in:
01.01.2019 | Editorials
Re-framing the question: Should hydroxyethyl starch be used in clinical practice?
verfasst von:
Ryan Zarychanski, MD, MSc, FRCPC, Alexis F. Turgeon, MD, MSc, FRCPC
Erschienen in:
Canadian Journal of Anesthesia/Journal canadien d'anesthésie
|
Ausgabe 1/2019
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Excerpt
The risk, benefits, and cost-utility of intravenous crystalloid and colloid fluids used in clinical medicine are the subject of active research and intense debate. The discussion concerning the use and safety of hydroxyethyl starch (HES) continues to feature prominently. In 2013, following the completion of three large randomized trials
1-
3 and a meta-analysis
4 that showed hydroxyethyl starch to be associated with increased mortality and use of renal replacement therapy, Health Canada issued a warning against the use of HES in critically ill patients, specifically those with sepsis, severe liver disease, or impaired kidney function.
5 Similar warnings about HES were issued by the Federal Drug Agency (FDA) and the European Medicines Agency (EMA).
6 The EMA recommendation further restricted the use of HES to treat hypovolemia due to acute blood loss when crystalloids alone are not considered sufficient. …
