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