Does resuscitation with the synthetic colloid, hydroxyethyl starch (HES) impact outcomes in ICU patients? This large, multicenter, randomized trial compared the use of HES with normal saline for fluid resuscitation in critically ill patients. The study involved 7000 patients and aimed to assess whether HES, a synthetic colloid, offered any advantage over the commonly used crystalloid, normal saline, in terms of mortality or kidney function. The results showed no significant difference in 90-day mortality between the two groups. However, significantly more patients in the HES group required renal replacement therapy. The trial raised important concerns about the safety of HES in intensive care, leading to changes in fluid resuscitation practices in critical care settings worldwide.