These metaanalyses take into account heterogeneous populations of patients with different therapeutic strategies. Recently, Perner et al. [ 8] have shown an increased risk of death (dead on day 90) in patients with severe sepsis who were assigned to receive fluid resuscitation with HES 130/0.42 (6% HES 130/0.42 in Ringer's acetate, last generation of HES) compared with those who received Ringer's acetate.