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

Table 8

Overview of randomized control trials related to coagulation defect and bleeding categorized by primary outcome.

Author, years	Fluid comparisons	N	Operation	Conclusion
Primary outcome: coagulation
Jin [25], 2010	LRS; 6% HES 130/0.4 (Voluven); 4% gelatin (Gelofusine)	36	Gastrectomy	HES impaired clot initiation and impaired platelet function; Gelatin reduced clot firmness; No difference in blood loss
Liang [31], 2010	6% HES 200/0.5 (HAES-steril6%); 6% HES 130/0.4 (Voluven)	35	Laparoscopy-assisted radical colectomy	HES 200/0.5 impaired clotting time, clot firmness, and impaired platelet function more than HES 130/0.4; No difference in blood loss
Hung [23], 2014	LRS; 6% HES 130/0.4 (Voluven)	80	Major abdominal surgery	HES 130/0.4 impaired clot initiation and strength; No difference in blood loss
Rasmussen [43], 2014	LRS; 6% HES 130/0.4 (Voluven)	33	Cystectomy	HES 130/0.4 impaired clot strength and firmness; HES 130/0.4 caused more blood loss than LRS
Rasmussen [44], 2015	Dextran70; LRS	37	Cystectomy	Dextran70 impaired clot firmness and incidence of blood loss >1500 mL; No difference in mean blood loss
Rasmussen [45], 2016	5% human albumin; LRS	39	Cystectomy	5% human albumin impaired clot firmness; No difference in blood loss
Primary outcome was another objective but also had these outcomes
Yates [16], 2014	Hartmann’s solution; 6% HES 130/0.4 (Volulyte)	202	Colorectal surgery	No significant difference in TEG or blood loss
Kancir [27], 2015	NSS; 6% HES 130/0.4 (Voluven)	36	Radical prostatectomy	Significant blood loss in HES

HES = hydroxyethyl starch, NSS = normal saline solution, LRS = lactated Ringer’s solution, and TEG = thromboelastogram.