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

Table 7

Overview of randomized control trials related to renal function and electrolyte imbalance (balanced vs. saline solution/other balanced solutions) categorized by primary outcome.

Author, year	Fluid compared	N	Operation	Conclusion
Primary outcome: renal function or electrolyte abnormality
Waters [52], 2001	NSS; LRS	66	Abdominal aortic aneurysm repair	NSS had more hyperchloremic metabolic acidosis; No difference in Cr, AKI but no K report
O’Malley [39], 2005	NSS; LRS	51	Living donor kidney transplant	NSS had more hyperchloremic metabolic acidosis; No difference in Cr, AKI, K, and incidence of dialysis to 6 months
Khajavi [28], 2008	NSS; LRS	54	Living donor kidney transplant	NSS had more hyperchloremic metabolic acidosis; NSS had higher K level postoperation; no difference in Cr level
Modi [37], 2012	NSS; LRS	72	Living donor kidney transplant	NSS had more hyperchloremic metabolic acidosis; NSS had higher K level postoperation; no difference in Cr level
Kim [29], 2013	NSS; Plasmalyte	60	Living donor kidney transplant	NSS had more negative base excess and chloride; No difference in urine output, Cr, Cl
Potura [40], 2015	NSS; Acetate-buffered crystalloid (Elomel-Isoton)	148	Cadaveric kidney transplant	NSS had more negative base excess; No difference in urine output, Cr, Cl, and dialysis; No difference in number of patients having K level >5.4
Weinberg [53], 2015	Hartmann solution; Plasmalyte	60	Major liver resection	Higher magnesium but lower calcium in Plasmalyte group; No difference in base excess and Cr
Weinberg [54], 2017	NSS; Plasmalyte	49	Cadaveric kidney transplant	NSS had more hyperchloremic metabolic acidosis and hyperkalemia which led to dialysis or medication treatment

NSS = normal saline solution, LRS = lactated Ringer’s solution, Cr = creatinine, AKI = acute kidney injury, and K = potassium.