de Jonge et al., Crit Care Med 2001
(Blood Loss, Surgical) :
Dextran, gelatin, and hydroxyethyl starch ( HES ) all can induce a specific decrease of von Willebrand factor and factor VIII : c. Blood coagulation is most impaired by dextran and high molecular weight HES, both associated with increased postoperative blood loss
Treib et al., Thromb Haemost 1997
(Blood Coagulation Disorders) :
Of particular importance is the fact that HES with a high in vivo MW affects factor VIII/von Willebrand factor which can lead to an acquired von Willebrand syndrome