Hydroxyethyl starch (HES), which is typically given to emergency room patients that have lost a lot of blood or are suffering systemic infection, is under the microscope again after recent clinical trial results indicate that the treatment may do more harm than good. The new data, published yesterday in The New England Journal of Medicine, indicated that of more than 6,600 patients treated with HES in intensive care units in Australia and New Zealand, 18 percent treated with HES died within 90 days compared to 17 percent treated with simple saline solution. Though that result isn't statistically significant, patients receiving HES were also more likely to require kidney replacement than patients receiving saline, and HES-treated patients experienced significantly higher rates of adverse events such as itching and bleeding.
"We need to consider more closely what fluid we give to specific patients and how much," lead author John Myburgh of The George Institute for Global Health in Sydney, Australia, told ScienceNOW. "These are really intravenous drugs and should be treated as such."
These latest data add to a body of literature that suggests problems with HES treatment. This past June, a Danish study suggested that patients receiving HES were significantly more likely to die within 90 days or to require kidney transplants than those getting an alternative solution called Ringer's acetate. That study kicked up controversy over a misplaced decimal point, which was subsequently corrected, and led the US Food and Drug Administration to consider discontinuing HES treatment for infection patients.