Colloids Versus Crystalloids: Is That the Real Problem?

Guarnieri, Marcello; Belletti, Alessandro; Meroni, Roberta; Bignami, Elena

doi:10.1053/j.jvca.2016.04.002

Cited by 1 publication

(2 citation statements)

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“…The incidence of mortality and acute kidney failure was suggested to increase when colloids were transfused into critically ill patients or cardiac surgery patients. 15,16 Cochrane review in 2018 and Scandinavian clinical practice guideline recommended to use crystalloids rather than colloid solusions. 17,18 However, in cardiac surgery colloids seemed to be efficient volume substitutes, [1][2][3] but their safety has been questioned.…”

Section: Discussionmentioning

confidence: 99%

“…It proposed avoiding colloids, including gelatin and HES, in critically ill patients. The incidence of mortality and acute kidney failure was suggested to increase when colloids were transfused into critically ill patients or cardiac surgery patients 15,16 . Cochrane review in 2018 and Scandinavian clinical practice guideline recommended to use crystalloids rather than colloid solusions 17,18 .…”

Section: Introductionmentioning

confidence: 99%

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Gelatin and the risk of bleeding after cardiac surgery

Koponen

Musialowicz

Lahtinen

2020

Acta Anaesthesiol Scand

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Gelatin and other colloids, such as hydroxyethyl starch (HES), have been used in cardiac surgery because of their ability to preserve intravascular volume (ie plasma expanders) better than crystalloids. 1-3 They are also used to maintain blood pressure and avoid blood product transfusions. 2,3 Unfortunately, gelatin and HES have been associated with impaired coagulation and hemostasis. 4,5 Even a small dose of gelatin has been shown to impair clot strength and platelet adhesion in cardiac surgery. 6 However, to the best of our knowledge, no clinical studies have shown that gelatin increases bleeding in cardiac surgery. 7,8 Increased bleeding in cardiac surgery has been associated with increased mortality and morbidity. 9,10 Even a modest increase in the chest tube drainage volume after cardiac surgery has been associated with higher 30-day mortality, a higher incidence of stroke, re-explorations or re-sternotomies, prolonged mechanical ventilation, and a prolonged length of stay in intensive care unit (ICU). 11,12 In addition, excessive postoperative bleeding increases costs after cardiac surgery. 13

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