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Gelatin and HES impair clot formation ex vivo

Gelatin 4% and hydroxyethyl starch (130/0.42) impair clot formation in a human ex vivo whole-blood resuscitation model
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · Added 15 September 2026

Ex vivo human whole-blood model testing graded dilution with gelatin 4%, HES 130/0.42 and a balanced crystalloid — both colloids produced a clearly hypocoagulable ROTEM profile (prolonged clotting and clot formation times, reduced alpha-angle and maximum clot firmness, worst with HES) while the crystalloid alone stayed haemostatically neutral, and combining crystalloid with colloid dilution worsened the coagulopathy further.

Study type

Simulation

Design

Ex vivo human whole-blood haemodilution model

Participants

Human whole-blood samples diluted with gelatin 4%, HES 130/0.42 and balanced crystalloid (number of donors not reported)

Main finding

Gelatin and HES produced a hypocoagulable ROTEM profile (prolonged clotting and clot formation times, reduced alpha-angle and MCF), worst with HES; balanced crystalloid alone remained haemostatically neutral, and crystalloid–colloid combinations showed non-linear, ratio-dependent coagulopathy.

Caveat

Ex vivo model without transfusion or clinical outcomes; donor sample size not reported.

Bottom line

Hypothesis-generating

Learning goal

Weigh the coagulopathy risks of colloid choices when resuscitating major trauma patients prehospital.

More

• Topic: Trauma
• Daily scan: 15 September 2026

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