Meybohm and colleagues hypothesise that so-called ‘correct’ administration of hydroxyethyl starch (HES) may be beneficial and may provide new guidelines for clinical use of HES, but this is not supported by trial data [1]. In contrast, subgrouping trials according to ‘presumable correct indication’ does not change the mortality estimate (see Figure 1). There is also very little statistical hete...

Large randomized trials on critically ill patients have related the use of hydroxyethyl starch (HES) to negative outcomes. In a recent comment we explained in detail why, from our point of view, transferring the results of VISEP, 6S and CHEST into daily ICU practice is as difficult as their extrapolation to perioperative treatment. Haase, Müller and Perner lately challenged this analysis. Howev...

A number of informal terms (e.g., Anthropocene, Anthropozoic, Psychozoic, Noozoic, and Technogene) have been used to designate the rock unit and time interval where the impact of collective human action on the Earth system is clearly recognizable (called here the Humanized Earth System or HES). Presently, Anthropocene is the most commonly used, and the International Commission on Stratigraphy i...

BACKGROUND Several plasma volume expander alternatives exist to enhance intravascular volume status in patients undergoing surgery. The optimal intravascular volume expander in the perioperative setting is currently unknown. Low molecular weight hetastarch, Voluven® (130/0.4), may have a better safety profile than high molecular weight hetastarch, Hextend® (450/0.7). We examined the clinical an...

Hypereosinophilic syndrome is a heterogeneous group of rare disorders characterized by marked blood or tissue eosinophilia resulting in a wide variety of clinical manifestations. Although the existence of clinical subtypes (or variants) of HES has been appreciated for some time, the recent characterization of some of these variants at the molecular and immunologic levels has demonstrated dramat...

THE hypothesis that saline administration results in dilutional acidosis was advanced by Shires and Holman in 1948. The antithesis, that physiologic defense mechanisms prevent reduction of bicarbonate concentration ([HCO3 ]) to the extent predicted by simple dilution, followed approximately 20 yr later and generally was accepted by 1975. In the 1990s, a variety of case reports and clinical stud...

To evaluate the transport properties of the alveolar epithelium, we instilled hetastarch (Het; 6%, 10 ml, 1 - 1 x 10(4) kDa) into the trachea of isolated rat lungs and then measured the molecular distribution of Het that entered the lung perfusate from the air space over 6 h. Het transport was driven by either diffusion or an oncotic gradient. Perfusate Het had a unique, bimodal molecular weigh...

Compared with hetastarch (HS), the low molecular weight analog pentastarch (PS) has been reported to be equally effective for granulocyte collection by centrifugal leukapheresis, to result in fewer adverse donor reactions (ADR), and to have a more rapid elimination profile. We prospectively compared the granulocyte collection efficiency (GCE), granulocyte yield, and ADR in 72 randomly paired gr...

PURPOSE OF REVIEW Infusion therapy is essential in intravascular hypovolaemia and extravascular fluid deficits. Crystalloidal fluids and colloidal volume replacement affect blood coagulation when infused intravenously. The question remains if this side-effect of infusion therapy is clinically relevant in patients with and without bleeding manifestations, and if fluid-induced coagulopathy is a r...