Winnipeg Free Press - PRINT EDITION

Blood expander found problematic in local study

Says commonly used HES can cause harm

  • Print

A Winnipeg-based research team has discovered a product used worldwide to resuscitate critically ill patients with low blood pressure may be doing more harm than good.

The team's research is being published in today's edition of the Journal of the American Medical Association. It concludes that hydroxyethyl starches (HES), the most common blood-volume expanders in use, can cause increased kidney failure and higher mortality rates than other products.

Dr. Ryan Zarychanski, a CancerCare Manitoba hematologist and the study's lead researcher, said publication of the team's findings could change the way hospitals and government regulators around the world view HES.

"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 examined 38 clinical trials involving corn-based HES solutions. The trials involved 10,880 patients from around the world. HES has been on the market since the 1980s.

Zarychanski, a critical care physician who also teaches at the University of Manitoba, 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 far less expensive than the product sold under such trade names as Hespan and Voluven.

HES and other synthetics were introduced to reduce the medical community's reliance on human blood products. Several of these alternatives, though, have been found to cause harm, prompting restrictions on their use.

"I'm expecting that physicians will immediately reconsider the use of (HES) 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.

Today's article is the second prestigious medical journal publication in the last six months for Zarychanski. In September, he was the lead author of an article that dominated the cover of Blood, the world's top journal on blood disorders. The report unlocked the secret to a mysterious blood disorder that could lead to improved treatment for patients.

Terry Klassen, an associate dean at the U of M's faculty of medicine, said publication of the HES article -- and a companion editorial on the subject -- in one of the top medical journals in the world "speaks to the quality of research" being done in Winnipeg. "I think it's terribly exciting," he said Tuesday.

Klassen said Zarychanski's study shows the need for "more full disclosure" on the results of clinical trials.

"You can't have industry not disclosing the whole story on a product because that will lead to a distorted view of whether something is safe and whether it works or not," he said.

Zarychanski said HES -- which has been widely used in Winnipeg -- became part of standard care in the absence of properly conducted studies to assess patient safety. These studies have only been recently conducted and were included in the analyses done by himself and his team.

Also participating in the study were Dr. Ahmed Abou-Setta, a physician and scientist at the University of Manitoba, and Dr. Alexis Turgeon, a physician and clinician-scientist at Laval University in Quebec City. Additional support for the research was provided by the George and Fay Yee Centre for Healthcare Innovation, a partnership between the U of M and the Winnipeg Regional Health Authority.

Republished from the Winnipeg Free Press print edition February 20, 2013 A6

Fact Check

Fact Check

Have you found an error, or know of something we’ve missed in one of our stories?
Please use the form below and let us know.

* Required
  • Please post the headline of the story or the title of the video with the error.

  • Please post exactly what was wrong with the story.

  • Please indicate your source for the correct information.

  • Yes


  • This will only be used to contact you if we have a question about your submission, it will not be used to identify you or be published.

  • Cancel

Having problems with the form?

Contact Us Directly
  • Print

You can comment on most stories on You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

You can comment on most stories on You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

Have Your Say

New to commenting? Check out our Frequently Asked Questions.

Have Your Say

Comments are open to Winnipeg Free Press print or e-edition subscribers only. why?

Have Your Say

Comments are open to Winnipeg Free Press Subscribers only. why?

The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.


Make text: Larger | Smaller


Key of Bart - Cali For Jets Nation

View more like this

Photo Store Gallery

  • Marc Gallant/Winnipeg Free Press. Local/Standup- BABY BISON. Fort Whyte Centre's newest mother gently nudges her 50 pound, female bull calf awake. Calf born yesterday. 25 now in herd. Four more calfs are expected over the next four weeks. It is the bison's second calf. June 7, 2002.
  • Someone or thing is taking advantage of the inactivity at Kapyong Barracks,hundreds of Canada Geese-See Joe Bryksa’s goose a day for 30 days challenge- Day 15- May 22, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)

View More Gallery Photos


Do you agree with the sale of the Canadian Wheat Board to foreign companies?

View Results

View Related Story

Ads by Google