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Use of Hydroxyethyl Starch for Fluid Resuscitation Poses 'Serious Safety Concerns'
By Joe Elia
Critically ill patients treated with hydroxyethyl starch face increased risks for kidney damage and mortality, according to a JAMA meta-analysis. The dangers, once considered of borderline significance, became apparent when the data of a disgraced researcher were removed from the analysis.
The researchers examined mortality and renal-outcome data from some 40 trials comparing hydroxyethyl starch with other fluids given to patients for volume resuscitation. Seven of those trials — by a researcher whose later work was retracted after a government investigation — were removed. After that removal, results changed from showing no mortality advantage with starch to a significant mortality risk. Kidney damage, as reflected by the need for renal-replacement therapy, also increased.
Editorialists point out the serious consequences to patients of scientific misconduct. They conclude: "The harms of hydroxyethyl starch most likely outweigh the benefits."
JAMA article (Free abstract)
JAMA editorial (Subscription required)
Background: Journal Watch General Medicine summary of recent hydroxyethyl starch trial (Your Journal Watch subscription required)
Published in Physician's First Watch February 20, 2013
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