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British Journal of Anaesthesia 2007 98(2):157-159; doi:10.1093/bja/ael359
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Hydroxyethyl starch: does our choice of colloid prevent or add to renal impairment?

The first 10% of the full text of this article appears below.

The controversy over colloid vs crystalloid has continued for years.1 Against this we need to balance the effects of too much or too little fluid23 and the difficulties of comparing critically ill patients. There is also some evidence that early volume restoration before definitive haemostasis may result in accelerated blood loss, hypothermia, and a dilutional coagulopathy in trauma.45 If this were not enough, we must also deal with the adverse effects of individual types of colloid, in this case, hydroxyethyl starch (HES) solutions.

HES solutions appear to be effective volume expanders, which because of their large molecules have the potential to stay in the circulation longer than crystalloids. As a result, biopsy samples from the left ventricle and gastrocnemius demonstrate fewer areas of endothelial . . . [Full Text of this Article]

G. H. Mills

Department of Anaesthesia and Intensive Care
Royal Hallamshire Hospital
Sheffield S10 2JF
UK
E-mail: g.h.mills@sheffield.ac.uk


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