Con: colloids should not be added to the pump prime

It is concluded that there is good scientific basis for an approach that avoids colloid priming solutions as routine for all adult CPB patients. There may be selected individuals who might benefit from colloid therapy; for instance, patients who are predicted to require high left atrial pressures postbypass, those who are borderline for getting through their surgical experience without a homologous red cell transfusion, and patients coming for surgery with a clinically important lung water elevation. In this time of cost constraints there are many more scientifically worthy therapies that could be made available to patients. We should focus on these and resist "luxury items" like routine colloid CPB priming solutions.