HES: time to change my mind?

Excerpt

I very well remember the presentation of Konrad Reinhart at the ESICM Lives Congress 2011 in Berlin about the recommendations of the task force on colloid volume therapy in critically ill patients, which were later published in this journal [1]. I was a believer and the consumption of HES in my anesthesia department in Eisenstadt Austria went down to a minimum over the next year and we abandoned any synthetic colloid and stopped using HES, not only in the ICU but also in anesthesia and in emergency medicine including obstetrics and trauma care. Since this is a radical decision, I followed the discussion about HES very carefully over the last years. Large trials were carried out and published and heavily criticized. On December 19th, 2013, the European Medicines Agency published a decision of the European Commission that HES solutions must no longer be used to treat patients with sepsis or burn injuries or critically ill patients, because of an increased risk of kidney injury and mortality, but HES wiould be available in restricted patient populations. Manufacturers were forced to include contraindications and warnings in the drug information. Usage of HES further went down and the discussion cooled down. Now in January 2018, PRAC and EMA started a new initiative to suspend the licence of HES in the EU, and the discussion started again [2]. …