Hydroxyethyl starch for perioperative fluid management: a critical appraisal

Fluid therapy is an essential component of perioperative care, and fluids are powerful tools to maintain or restore the effective circulating blood volume of patients undergoing major surgery. In fact, perioperative fluid management affects clinical outcomes, and appropriate fluid balance may reduce postoperative morbidity.1 However, the type, dose, and timing of fluid administration have been debated for many years, and evidence in the field is constantly emerg ing. Perhaps the foremost dispute on this topic is related to the type of fluid, with the choice between colloids versus crystalloids remaining the most controversial