Intravenous Fluid of Choice in Major Abdominal Surgery: A Systematic Review

Table 4

Overview of randomized control trials related to microcirculation categorized by primary outcome.

Author, year	Fluid compared	N	Operation	Conclusion
Primary outcome: Gastric pH and Pg-aCO2
Marik [35], 1997	LRS; HES 670/0.75 (hetastarch)	30	Abdominal aortic aneurysm repair	HES 670/0.75 improved splanchnic mucosal blood flow (gastric pH)
Rittoo [46], 2002	6% HES 200/0.62 (Elohes); 4% gelatin (Gelofusine)	22	Abdominal aortic aneurysm repair	HES 200/0.5 improved splanchnic mucosal blood flow (gastric pH)
Mahmood [34], 2009	6% HES 200/0.62 (Elohes); 6% HES 130/0.4 (Voluven); 4% gelatin (Gelofusine)	62	Abdominal aortic aneurysm repair	HES is better than gelatin but HES 200/0.62 was the best in decreasing gastric pH after clamp off
Deng [21], 2017	LRS; 4% gelatin (Gelofusine); 4.5% NaCl in 7.6% HES40	36	Laparoscopic colonic surgery	No significant splanchnic mucosal blood flow (Pg-aCO2)
Zhu [57], 2018	LRS; 4% gelatin (Gelofusine); 4.5% NaCl in 7.6% HES 40	71	Laparoscopic colonic surgery	4% gelatin was the best in maintaining gastric pH > 7.32 for more than 60 minutes of operation

HES = hydroxyethyl starch, NaCl = sodium chloride, and LRS = lactated Ringer’s solution.