Hemostatic and electrolyte effects of hydroxyethyl starches in patients undergoing posterior lumbar interbody fusion using pedicle screws and cages.

Confirming previous studies, dilutional coagulopathy was more pronounced after 15 ml/kg slowly degradable HES (Hextend) vs. rapidly degradable HES (Voluven) and postoperative transfusion rate at a high hematocrit trigger was higher after Hextend. Future studies should implement a functional fibrinogen assay (e.g. FIBTEM) and individualize the dose of fluid therapy.

– Sybille Kozek-Langenecker