Understanding the Harms of HES: A Review of the Evidence to Date

dc.contributor.authorÜnal, M. Necmettin
dc.contributor.departmentTıp Fakültesitr_TR
dc.date.accessioned2020-11-19T07:18:58Z
dc.date.available2020-11-19T07:18:58Z
dc.date.issued2019
dc.description.abstractIntravenous (IV) fluid resuscitation is one of the most common interventions in intensive care medicine. Despite clear guidelines, the choice of IV fluid is largely dependent on physician preference instead of high-quality evidence of efficacy and safety. This is particularly the case for synthetic colloids, such as hydroxyethyl starch (HES). The use of HES in critical care has been associated with increased rates of acute kidney injury (AKI), renal replacement therapy and mortality. In light of this, current guidelines and scientific and regulatory bodies do not recommend the use of HES for fluid therapy in critical illness and caution against its use in many other settings. Despite this, HES products are still debated and used. Awareness of the indications, contraindications, doses, benefits and adverse effects for IV fluids, as well as recommendations from scientific and regulatory bodies, is essential to guarantee patients' safety. Poor awareness of optimal IV fluid therapy has recently been revealed in some countries including Turkey. Therefore, we provide a review of fluids used for resuscitation, discuss safety data and adverse effects of HES, such as increased AKI and mortality, and discuss recent updates from scientific and regulatory bodies in order to raise awareness of fluid therapy. We conclude that given the lack of a clear benefit of HES in any clinical setting and the availability of safer alternatives, such as crystalloids and albumin, HES should be avoided.tr_TR
dc.description.indexPubmed
dc.identifier.endpage91tr_TR
dc.identifier.issue2tr_TR
dc.identifier.startpage81tr_TR
dc.identifier.urihttps://doi.org/10.5152/TJAR.2019.72681tr_TR
dc.identifier.urihttp://hdl.handle.net/20.500.12575/72434
dc.identifier.volume47tr_TR
dc.language.isoentr_TR
dc.relation.isversionof10.5152/TJAR.2019.72681tr_TR
dc.relation.journalTurk J Anaesthesiol Reanim .tr_TR
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıtr_TR
dc.subjectcritical illnesstr_TR
dc.subjectAcute kidney injurytr_TR
dc.subjectAKItr_TR
dc.titleUnderstanding the Harms of HES: A Review of the Evidence to Datetr_TR
dc.typeArticletr_TR

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