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This manuscript reports consensus recommendations based on analysis of the literature (meta-analyses, systematic reviews and clinical studies) regarding the safety and efficacy of the colloids (hydroxyethyl starches [HES], gelatins and human albumin) that are most widely used in critically ill patients. Whereas evidence was found against the use of HES with molecular weights over 200 kDa and/or degree of substitution >0.4 in patients with severe sepsis or risk of acute kidney injury (grade 1B) and against that of albumin in patients with head injury (grade 1C), differences of opinion among members of the task force were noted for other clinical situations or solutions (limit the use of HES 130/0.4 and gelatin in clinical practice [grade 2B and 2C]). For these reasons, this artilcle is not likely to change clinical practice.

– Michael Piagnerelli