Use of Acetate-Buffered Crystalloid Solutions for Fluid Therapy in Abdominal Surgery (Review)

Infusion therapy is one of the most frequently prescribed treatments in hospitalized patients. Fluid maintenance and resuscitation is an important strategy in major surgery. Acetate-buffered balanced crystalloid fluids may influence acid-base status, intracellular and extracellular water content, plasma electrolyte composition and have a favorable impact on renal, hepatic, and splanchnic microcirculation.

Aim was to evaluate current evidence of efficacy and safety of acetate-buffered crystalloid solutions for fluid therapy in abdominal surgery in adults.

Materials and methods. Medline, the Cochrane Library, eLIBRARY.ru were searched up to 31 May 2020 (additional search in November 2020) using the key words «acetate» AND «buffers» OR «buffered» AND «crys-talloid solutions» OR «crystalloids». Studies published after 2009 in English and Russian were included. Systematic review was conducted in accordance with PRISMA guidelines using specified PICO(S) criteria.

Results. The total of 62 studies were identified from all databases. Out of them 11 full-text publications were considered eligible, 6 of them were included into the final review. Acetate-buffered crystalloid solutions have a favorable impact on microcirculation. Metabolic alkalosis after the fluid infusion did not occur in all the studies; potassium levels remained stable, also.

Conclusion. Efficacy (based on acid-base status, hemodynamic parameters) of the acetate-buffered crystalloid solutions for fluid therapy during the abdominal surgery in adults patients was confirmed with the A level of evidence.

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