Exclusion of suspect data raises question mark over safety of common plasma substitute

Hydroxyethyl starch, a commonly used plasma substitute, is associated with increased risk of death and acute kidney injury in critically ill patients needing an increase in blood fluid volume, according to a new meta-analysis1 that excluded trials from an investigator some of whose research has been retracted because of scientific misconduct.

“This study highlights the serious implications of scientific misconduct on patient safety,” warned Massimo Antonelli, professor of intensive care medicine at the Università Cattolica del Sacro Cuore, Rome, Italy, in an accompanying editorial.2 He added that it illustrated the importance of updating guidelines regularly as the evidence base changes.

Synthetic colloids such as hydroxyethyl starch were approved in the 1960s without …