Safety and efficacy of hydroxyethyl starch

Abstract

Hydroxyethyl starch (HES) is the most frequently used colloid worldwide. In addition, low molecular weight HES is usually not associated with kidney injury or bleeding. However, recent clinical trials have revealed that HES, particularly 6% HES (130/0.4), is associated with kidney injury in septic patients. The current evidence for perioperative 6% HES (130/0.4) administration is difficult to assess because of research misconduct by Dr. Boldt. Further, in 2012, 6% HES (70/0.5) is the only formulation available in Japan. Thus, although perioperative 6% HES (70/0.5) is not associated with either kidney injury or bleeding, very few clinical trials have evaluated its efficacy or side effects. Because the safety of 6% HES (70/0.5) with regard to sepsis has not been confirmed yet, it should therefore be used with caution in clinical settings.