“I would have everie man write what he knowes and no more.”–Montaigne BRITISH JOURNAL OF ANAESTHESIA

Hydroxyethyl starch: does our choice of colloid prevent or add to renal impairment? 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 fluid2 3 and the difficulties of com-paring 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.4 5 If this were not enough, we must also deal with the adverse effects of indi-vidual 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 gastro