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Among other major methodological limitations, unclear group allocations (e.g. exposure to a mixture of various fluids in all groups, even more HES as pump prime in the crystalloid group, median 0 mL/kg gelatin until day 3 in the gelatin group) impede the conclusion that crystalloids alone may be the best option. Suboptimal dosing of colloids (e.g. primarily based on hemodynamic pressure parameters, HES given over 3 days) prohibits meaningful characterization of crystalloid:colloid ratios.

– Sibylle Kozek-Langenecker