Is the literature inconclusive about the harm from HES? No

Excerpt

Colloid solutions may be more effective than crystalloid solutions in expanding the intravascular space, which may result in improved hemodynamics and reduced tissue edema. Whether this is clinically important is unknown. Despite lack of evidence of overall benefit in terms of clinical or patient-important outcome measures, hydroxyethyl starch (HES), an artificial colloid solution, has been used in a variety of clinical settings to treat hypovolemia including during surgery, after trauma and burns, in sepsis, and in critically ill patients. As we will outline below, HES has clear side effects based on well-described pathophysiologic pathways resulting in worse outcome in critically ill patients. …