Hydroxyethyl starch: putting patient safety first.

The authors argue for the need to consider patient safety when deciding on whether to recommend the use of hydroxyethyl starch (HES) for all indications. They discuss the basis of recommendations from the European Medicines Agency (EMA) Coordination Group for Mutual Recognition and Decentralised Procedures--Human (CMDh) that HES may be used in severe haemorrhage. A brief background on the suspension of HES licensing by the EMA Pharmacovigilance Risk Assessment Committee (PRAC) is included.