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Background  Plasma expanders are commonly used in the management of critically ill patients, which may exhibit altered hemorheology. We evaluated the effects of various synthetic colloids and Lactated Ringer’s (LR) solution on hemorheological parameters  in vitro  and in a rodent hemorrhagic shock model.    Methods  For the  in vitro  experiments, rat blood was incubated with hydroxyethyl starch (HES) 130/0.4, HES 200/0.5, succinylated gelatine (GEL), or LR at various ratios. The control consisted of blood without dilution. The hemorheological parameters were measured after a 15-min incubation. For the  in vivo  study, rats were subjected to a severe volume-controlled hemorrhage and were resuscitated using a colloid solution (HES 130/0.4, HES 200/0.5, or GEL) or LR. The hemorheological parameters were measured 2 h after resuscitation.    Results  The GEL significantly elevated the plasma viscosity compared to the other groups. In the  in vitro  study, GEL and LR accelerated the erythrocyte aggregation. There was no significant difference between HES 130/0.4, HES 200/0.5, and control groups regarding the aggregation amplitude and index. In the  in vivo  study, the aggregation amplitude increased significantly in the GEL group compared to the HES 130/0.4, HES 200/0.5, LR, and sham groups. There was no significant difference between the groups with respect to the elongation index  in vivo .    Conclusions  Hydroxyethyl starch did not change the erythrocyte aggregation compared to the control. GEL significantly accelerates the erythrocyte aggregation and elevates the plasma viscosity compared to hydroxyethyl starch. The  in vitro  hemorheological measurements most likely provide hints for the  in vivo  study.

Effects of synthetic colloid and crystalloid solutions on hemorheology in vitro and in hemorrhagic shock