Review Article

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

Table 6

Overview of randomized control trials related to renal function (colloid vs. colloid/crystalloid) categorized by primary outcome.

Author, yearFluid comparedNOperationConclusion

Primary outcome: renal function (serum Cr, GFR, neutrophil gelatinase-associated lipocalin, urine albumin, and cystatin C)
Mahmood [33], 20076% HES 200/0.62 (Elohes)
6% HES 130/0.4 (Voluven)
4% gelatin (Gelofusine)
62Abdominal aortic aneurysm repairLess derangement in marker of glomerular filtration and tubular function in both HES groups
No difference in AKI or RRT
Mukhtar [38], 20095% human albumin
6% HES 130/0.4 (Voluven)
40Living donor liver transplantNo difference in serum Cr, CrCl, or cystatin C level
No difference in AKI or RRT
Demir [20], 20156% HES 130/0.4 (Voluven)
4% gelatin (Gelofusine)
36Living donor liver transplantSignificantly decreased GFR in gelatin group
No difference in AKI or RRT
Kancir [27], 20156% HES 130/0.4 (Voluven)
NSS
36ProstatectomyNo significant difference in renal impairment by U-NGAL, P-NGAL, and serum Cr
Kammerer [26], 20185% human albumin
6% HES 130/0.4 (Voluven)
100CystectomyNo significant difference in renal impairment by cystatin C ratio, P-NGAL, and GFR

Primary outcome was another objective but also had these outcomes
Rittoo [47], 20056% HES 200/0.62 (Elohes)
4% gelatin (Gelofusine)
40Abdominal aortic aneurysm repairLess derangement in marker of glomerular function in HES group
Ando [18], 2008Acetate Ringer
HES 70/0.5 (Hespander)
20Major abdominal surgeryNo difference in glomerular function (urine Albumin/ Cr ratio), GFR
Feldheiser [15], 2013Jonosteril
6% HES130/0.4 (Volulyte)
48Cytoreductive surgeryNo significant renal function impairment (P-NGAL and Cr)
Yates [16], 2014Hartmann’s solution
6% HES130/0.4 (Volulyte)
202Colorectal surgeryNo significant renal function impairment
Joosten [17], 2018Plasmalyte
6% HES130/0.4 (Volulyte)
160Major abdominal surgeryNo significant renal function impairment or RRT

HES = hydroxyethyl starch, AKI = acute kidney injury, RRT = renal replacement therapy, CrCl = creatinine clearance, GFR = glomerular filtration rate, NSS = normal saline solution, U-NGAL = urine neutrophil gelatinase-associated lipocalin, P-NGAL = plasma neutrophil gelatinase-associated lipocalin, and Cr = creatinine.