OPTIMIZING INTRAOPERATIVE FLUID MANAGEMENT: EVIDENCE FROM A THREE-ARM TRIAL OF CRYSTALLOIDS AND COLLOIDS IN ABDOMINAL SURGERY

Background: Optimal intraoperative fluid management remains debated,with crystalloids associated with tissue edema and colloids offering greater plasma expansion but raising safety concerns. This study compared Ringers lactate (RL) alone with RL supplemented by 6% hetastarch (HS-RL) or 6% tetrastarch (TS-RL) in patients undergoing major gastrointestinal surgery.

Methods: In this randomized controlled trial,120 patients were allocated into three groups(RL, HS-RL, TS-RL; n=40 each). Perioperative fluid management was guided by central venous pressure.Baseline characteristics and surgical distribution were comparable. Outcomes included intraoperative fluid requirements, gastrointestinal recovery, ambulation, ICU and hospital stay, and postoperative complications.

Conclusion: Supplementing RL with balanced colloids enhanced recovery without increasing renal risk or mortality. Judicious colloid use may be a safe and effective intraoperative strategy in gastrointestinal surgery.