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Medicine› Surgery› Hemodynamic Monitoring and Therapy

Critical care — Hydroxyethyl starch 130/0.4 for fluid resuscitation

Submitted 2026-10-22

Field: Medicine › SurgeryType: No effect foundArea: critical careArea: kidney diseaseTarget: Hydroxyethyl starch 130/0.4 for fluid resuscitationStage: randomized trial

Hypothesis

Resuscitating ICU patients with 6% hydroxyethyl starch instead of saline would be at least as safe and improve survival.

What failed

Among 7,000 ICU patients, 90-day mortality was 18.0% with starch vs 17.0% with saline (RR 1.06, P=0.26), and more starch patients needed renal-replacement therapy (7.0% vs 5.8%, P=0.04).

Broken assumption

A synthetic colloid resuscitates ICU patients at least as safely as saline and improves survival.

Why

No survival advantage, and a signal of kidney harm: more renal-replacement therapy and significantly more adverse events with starch.

From the published paper: Myburgh JA, Finfer S, Bellomo R, et al. (CHEST). N Engl J Med, 2012. NCT00935168 ↗

Research ideas from this failure

Unvetted lead — read the papers

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Links in published research

Where this experiment's genes are known to matter outside its own research area, and the papers behind those links. Sources: Open Targets Platform and Europe PMC.