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February 20, 2013

Hydroxyethyl Starch for Intravenous Volume Replacement: More Harm Than Benefit

Author Affiliations

Author Affiliations: Institute of Intensive Care Medicine and Anesthesiology, Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.

JAMA. 2013;309(7):723-724. doi:10.1001/jama.2013.851

Hydroxyethyl starches are synthetic fluid products used commonly in clinical practice worldwide. Synthetic colloids received market approval in the 1960s without evaluation of their efficacy and safety in large phase 3 clinical trials. Subsequent studies reported mixed evidence on their benefits and harms. Adding to the controversy, a number of studies reporting benefit were conducted by Dr Joachim Boldt, an investigator who had a large number of studies retracted for ethical or scientific misconduct.1 Two recent large randomized controlled trials2,3 have fueled further debate over the safety of hydroxyethyl starch for routine clinical use.