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Blood volume expander may do more harm than good: Winnipeg research team
Dr. Ryan Zarychanski (KEN GIGLIOTTI / WINNIPEG FREE PRESS) Photo Store
A Winnipeg-based research team has concluded that a product used worldwide to resuscitate critically ill patients with low blood pressure may be doing more harm than good.
The team, whose findings will be published Wednesday in the Journal of the American Medical Association, discovered that use of a commonly used blood volume expander can lead to increased kidney failure and mortality.
Dr. Ryan Zarychanski, a CancerCare Manitoba blood disorder specialist and the study’s lead researcher, said publication of the research could change the way hospitals and regulators around the world view the product.
"I’m really excited to get this out because by using the product less more people will actually live," he said in an interview.
Zarychanski and his team, which included researchers at the University of Manitoba and Laval University in Quebec City, examined 38 clinical trials in support of corn-based hydroxyethyl starches (HES). The trials involved 10,880 patients from around the world.
Zarychanski said problems with HES might have been detected earlier if not for previously published studies conducted by a German investigator that were later retracted due to scientific misconduct.
"When you remove the data from that one investigator [seven studies' worth], the evidence of harm is even more clear," he said.
Zarychanski said there are several alternatives to HES — some of them vastly less expensive than the product that is sold under the trade names of Hespan, Voluven and Volulyte b. HES has been in use since the 1980s.
"I’m expecting that physicians will immediately reconsider the use of the product on a day-to-day basis. I’m expecting that hospitals will re-examine their decision to carry this... or to carry it without restrictions," he said.
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