Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care

The administration of intravenous fluids to increase intravascular volume is a frequent intervention in the intensive care unit (ICU), but the choice of resuscitation fluid remains controversial.1,2 Globally, 0.9% sodium chloride (saline) is the most commonly used fluid, although colloids are administered as often as crystalloids, and hydroxyethyl starch (HES) is the most frequently used colloid.3 Several studies have questioned the safety of HES in critically ill patients, with particular concern that its use increases the risk of acute kidney injury.4,5 Most concern has focused on the use of concentrated HES solutions (10%) with a molecular weight of . . .