A 72-year-old patient with septic shock receives hydroxyethyl starch (HES 130/0.4) for volume resuscitation. Based on the 6S and CHEST trials, which adverse outcome is MOST strongly associated with HES use compared with crystalloids?
- A Hypernatremia
- B Increased need for renal replacement therapy ✓
- C Hypokalemia
- D Hepatic failure
Correct answer: B. Increased need for renal replacement therapy
Explanation
The 6S and CHEST trials demonstrated that HES 130/0.4 increases the risk of renal replacement therapy and mortality in critically ill patients compared with crystalloids. This led to regulatory warnings against HES use in sepsis. Hypernatremia and hypokalemia are not characteristic adverse effects of starch-based colloids.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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