From the publishers of The New England Journal of Medicine

Save time and stay informed. Our physician-editors offer you clinical perspectives on key research and news.

Like this article?

Get your free daily medical news from Physician's First Watch.

RSS

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 Seven of those trials — by a researcher whose later work was retracted after a government investigation — were removed.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."

LINK(S):

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

Your Remark:

Reader Remarks are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

The editors of Journal Watch may respond to Reader Remarks, but we cannot promise to respond to a particular remark.

Fields marked with an * are required.

Name as you'd like it to appear:

Submitting a comment indicates you have read and agreed to the remark guidelines and declare:*

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.

 

CLEAR erases anything you've added in any part of the form. CONTINUE allows you to check your entire post (and edit it if necessary) before submitting.

To ensure that your Reader Remark is not formatted as one long paragraph, precede new paragraphs with either a blank line or an indentation.

Search

Advanced

Sign-In

Forgot your password? Login via Athens
or your institution

New to Journal Watch?

E-mail Alerts

Delivered to your inbox.
Tailored to your interests. Free.

Sign Up Now!

Journal Watch Newsletters

Available in 13 specialties with convenient delivery and 10 free online CME exams.

Subscribe Now!

Copyright © 2013. Massachusetts Medical Society. All rights reserved.