This prospective single-blind study reports that, in comparison to Ringer acetate, both 6% HES 130/0.4 and 4% modified fluid gelatin administered postoperatively impair clot formation and strength in a dose-related fashion in cardiac surgery patients. The clinical relevance of this observation remains uncertain as postoperative blood loss and allogeneic blood transfusion were not different between the three groups. It is also interesting to note that the authors compared a “balanced” crystalloid solution to two “unbalanced” (i.e. NaCl 0.9%) colloids. There is some evidence that the solvent of the infused solution may influence the coagulation parameters measured by ROTEM while, again, the clinical relevance of these observations remains to be demonstrated.
– Philippe Van der Linden