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

Table 5

Overview of randomized control trials related to anti-inflammatory parameters and vascular permeability categorized by primary outcome.

Author, year	Fluid compared	N	Operation	Conclusion
Primary outcome: inflammatory mediators (IL-6, CRP, ICAM-1, and vWF) and vascular permeability (urine albumin/Cr ratio)
Rittoo [46], 2002	6% HES 200/0.62 (Elohes); 4% gelatin (Gelofusine)	22	Abdominal aortic aneurysm repair	HES 200/0.62 lowered CRP but no difference in IL-6 level
Rittoo [47], 2005	6% HES 200/0.62 (Elohes); 4% gelatin (Gelofusine)	40	Abdominal aortic aneurysm repair	HES 200/0.62 decreased inflammatory process and reduced endothelial activation
Mahmood [33], 2007	6% HES 200/0.62 (Elohes); 6% HES 130/0.4 (Voluven); 4% gelatin (Gelofusine)	62	Abdominal aortic aneurysm repair	Less derangement in marker of glomerular and tubular function in HES 200/0.62 and HES130/0.4
Ando [18], 2008	HES 70/0.5 (Hespander); Acetate Ringer	20	Major abdominal surgery	No significant difference in inflammatory markers and vascular permeability
Primary outcome was another objective but also had these outcomes
Mahmood [34], 2009	6% HES 200/0.62 (Elohes); 6% HES 130/0.4 (Voluven); 4% gelatin (Gelofusine); Endotoxin level increased in gelatin group	62	Abdominal aortic aneurysm repair	HES 200/0.62 mostly decreased inflammatory process (CRP, but not lung injury score)
Yates [16], 2014	6% HES130/0.4 (Volulyte); Hartmann’s solution	202	Colorectal surgery	No significant difference in inflammatory marker

IL-6 = interleukin-6; CRP = C-reactive protein; ICAM-1 = intercellular adhesion molecule-1; vWF = von Willebrand factor; Cr = creatinine; HES = hydroxyethyl starch; GI = gastrointestinal; POD = postoperative day.