11.09.07 Choice of fluid

Autologous blood

    • Great if you can get it

    • Blood lost during surgery can be re-infused

      • From bypass machine

      • Using cell-saver suction device

Allogenic blood

    • Risk of undetected infections

    • Cost

    • Immune reaction

Human albumin

    • Expensive

    • May avoid hypoalbinaemia and thus improve outcome

Hydroxyethyl starch

    • Potential effects on blood clotting


    • Smaller molecular weight, so not as effective at expanding vascular volume


    • Hyperchloraemia may cause acidosis

Hartmann's solution

    • Mildly hypotonic, so may exacerbate oedema