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Reference flow chart
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Figure 1

Reference flow chart

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Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
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Figure 2

Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
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Figure 3

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Comparison 1 Intervention versus control, Outcome 1 Mortality.
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Analysis 1.1

Comparison 1 Intervention versus control, Outcome 1 Mortality.

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Comparison 1 Intervention versus control, Outcome 3 Number requiring allogeneic blood transfusion.
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Analysis 1.3

Comparison 1 Intervention versus control, Outcome 3 Number requiring allogeneic blood transfusion.

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Comparison 1 Intervention versus control, Outcome 4 Red cell transfusion.
Figuras y tablas -
Analysis 1.4

Comparison 1 Intervention versus control, Outcome 4 Red cell transfusion.

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Comparison 1 Intervention versus control, Outcome 5 Fresh frozen plasma.
Figuras y tablas -
Analysis 1.5

Comparison 1 Intervention versus control, Outcome 5 Fresh frozen plasma.

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Comparison 1 Intervention versus control, Outcome 6 Operating time (minutes).
Figuras y tablas -
Analysis 1.6

Comparison 1 Intervention versus control, Outcome 6 Operating time (minutes).

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Comparison 1 Intervention versus control, Outcome 7 Hospital stay (days).
Figuras y tablas -
Analysis 1.7

Comparison 1 Intervention versus control, Outcome 7 Hospital stay (days).

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Comparison 1 Intervention versus control, Outcome 8 Transection blood loss (ml).
Figuras y tablas -
Analysis 1.8

Comparison 1 Intervention versus control, Outcome 8 Transection blood loss (ml).

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Comparison 1 Intervention versus control, Outcome 9 Operative blood loss (ml).
Figuras y tablas -
Analysis 1.9

Comparison 1 Intervention versus control, Outcome 9 Operative blood loss (ml).

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Comparison 2 Peri‐operative morbidity, Outcome 1 Low CVP versus control.
Figuras y tablas -
Analysis 2.1

Comparison 2 Peri‐operative morbidity, Outcome 1 Low CVP versus control.

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Comparison 2 Peri‐operative morbidity, Outcome 2 Autologous blood donation versus control.
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Analysis 2.2

Comparison 2 Peri‐operative morbidity, Outcome 2 Autologous blood donation versus control.

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Comparison 2 Peri‐operative morbidity, Outcome 3 Haemodilution versus control.
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Analysis 2.3

Comparison 2 Peri‐operative morbidity, Outcome 3 Haemodilution versus control.

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Comparison 2 Peri‐operative morbidity, Outcome 4 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES).
Figuras y tablas -
Analysis 2.4

Comparison 2 Peri‐operative morbidity, Outcome 4 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES).

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Comparison 2 Peri‐operative morbidity, Outcome 5 Hypoventilation versus control.
Figuras y tablas -
Analysis 2.5

Comparison 2 Peri‐operative morbidity, Outcome 5 Hypoventilation versus control.

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Comparison 3 Bilirubin (micromol/litre), Outcome 1 Low CVP versus control.
Figuras y tablas -
Analysis 3.1

Comparison 3 Bilirubin (micromol/litre), Outcome 1 Low CVP versus control.

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Comparison 4 Prothrombin activity, Outcome 1 Low CVP versus control.
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Analysis 4.1

Comparison 4 Prothrombin activity, Outcome 1 Low CVP versus control.

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Comparison 4 Prothrombin activity, Outcome 2 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES).
Figuras y tablas -
Analysis 4.2

Comparison 4 Prothrombin activity, Outcome 2 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES).

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Comparison 5 Aspartate transaminase (international units/litre), Outcome 1 Low CVP versus control.
Figuras y tablas -
Analysis 5.1

Comparison 5 Aspartate transaminase (international units/litre), Outcome 1 Low CVP versus control.

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Comparison 5 Aspartate transaminase (international units/litre), Outcome 2 Hypoventilation versus control.
Figuras y tablas -
Analysis 5.2

Comparison 5 Aspartate transaminase (international units/litre), Outcome 2 Hypoventilation versus control.

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Comparison 6 Alanine transaminase (international units/litre), Outcome 1 Low CVP versus control.
Figuras y tablas -
Analysis 6.1

Comparison 6 Alanine transaminase (international units/litre), Outcome 1 Low CVP versus control.

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Comparison 1. Intervention versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

8

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Low CVP versus control

3

177

Risk Ratio (M‐H, Fixed, 95% CI)

0.36 [0.02, 8.43]

1.2 Autologous blood donation versus control

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Haemodilution versus control

2

150

Risk Ratio (M‐H, Fixed, 95% CI)

0.35 [0.04, 3.32]

1.4 Haemodilution with controlled hypotension versus control

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.5 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES)

1

12

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.15, 61.74]

1.6 Hypoventilation versus control

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Peri‐operative morbidity

Other data

No numeric data

2.1 See analysis 2

Other data

No numeric data

3 Number requiring allogeneic blood transfusion Show forest plot

8

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Low CVP versus control

3

177

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.42, 1.03]

3.2 Autologous blood donation versus control

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.3 Hemodilution versus control

3

233

Risk Ratio (M‐H, Fixed, 95% CI)

0.41 [0.25, 0.66]

3.4 Hemodilution with controlled hypotension versus control

1

20

Risk Ratio (M‐H, Fixed, 95% CI)

0.05 [0.00, 0.72]

3.5 Hypoventilation versus control

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.77 [0.18, 3.22]

4 Red cell transfusion Show forest plot

6

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

4.1 Low CVP versus control

2

135

Mean Difference (IV, Fixed, 95% CI)

‐0.00 [‐0.00, 0.00]

4.2 Haemodilution versus control

2

150

Mean Difference (IV, Fixed, 95% CI)

‐0.09 [‐0.48, 0.29]

4.3 Haemodilution with controlled hypotension versus control

1

20

Mean Difference (IV, Fixed, 95% CI)

‐665.0 [‐818.71, ‐511.29]

4.4 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES)

1

12

Mean Difference (IV, Fixed, 95% CI)

167.0 [‐606.55, 940.55]

4.5 Hypoventilation versus control

1

79

Mean Difference (IV, Fixed, 95% CI)

‐56.00 [‐155.73, 39.73]

5 Fresh frozen plasma Show forest plot

1

Std. Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 Low CVP versus control

1

50

Std. Mean Difference (IV, Fixed, 95% CI)

‐1.22 [‐1.83, ‐0.62]

6 Operating time (minutes) Show forest plot

5

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Low CVP versus control

2

90

Mean Difference (IV, Fixed, 95% CI)

‐24.69 [‐44.28, ‐5.09]

6.2 Hemodilution versus control

2

208

Mean Difference (IV, Fixed, 95% CI)

‐28.86 [‐57.37, ‐0.35]

6.3 Hemodilution with bovine haemoglobin (HBOC‐201) versus hemodilution with hydroxy ethyl starch (HES)

1

12

Mean Difference (IV, Fixed, 95% CI)

23.0 [‐83.60, 129.60]

7 Hospital stay (days) Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Low CVP versus control

2

135

Mean Difference (IV, Fixed, 95% CI)

‐4.53 [‐7.38, ‐1.68]

7.2 Hemodilution versus control

1

130

Mean Difference (IV, Fixed, 95% CI)

0.0 [‐2.66, 2.66]

7.3 Haemodilution with bovine haemoglobin (HBOC‐201) versus hemodilution with hydroxy ethyl starch (HES)

1

12

Mean Difference (IV, Fixed, 95% CI)

2.30 [‐7.52, 12.12]

8 Transection blood loss (ml) Show forest plot

4

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 Low CVP versus control

2

135

Mean Difference (IV, Fixed, 95% CI)

‐81.71 [‐219.79, 56.37]

8.2 Autologous blood donation versus control

1

79

Mean Difference (IV, Fixed, 95% CI)

‐90.0 [‐171.60, ‐8.40]

8.3 Hypoventilation versus control

1

79

Mean Difference (IV, Fixed, 95% CI)

95.0 [‐186.40, 376.40]

9 Operative blood loss (ml) Show forest plot

7

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

9.1 Low CVP versus control

3

175

Mean Difference (IV, Fixed, 95% CI)

‐419.35 [‐575.06, ‐263.63]

9.2 Autologous blood donation versus control

1

79

Mean Difference (IV, Fixed, 95% CI)

‐37.0 [‐100.51, 26.51]

9.3 Hemodilution versus control

2

98

Mean Difference (IV, Fixed, 95% CI)

1.53 [‐102.37, 105.44]

9.4 Hemodilution with controlled hypotension versus control

1

20

Mean Difference (IV, Fixed, 95% CI)

‐245.00 [‐357.80, ‐136.20]

9.5 Hemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES)

1

12

Mean Difference (IV, Fixed, 95% CI)

370.0 [‐1103.59, 1843.59]

10 Bilirubin (micromol/litre)

Other data

No numeric data

10.1 See analysis 3

Other data

No numeric data

11 Prothrombin activity

Other data

No numeric data

11.1 See analysis 4

Other data

No numeric data

12 AST (IU/L)

Other data

No numeric data

12.1 See analysis 5

Other data

No numeric data

13 ALT (IU/L)

Other data

No numeric data

13.1 See analysis 6

Other data

No numeric data
Figuras y tablas -
Comparison 1. Intervention versus control
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Comparison 2. Peri‐operative morbidity

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Low CVP versus control Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 All peri‐operative morbidities

2

90

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.28, 1.34]

1.2 Intra‐abdominal collections

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.12, 3.57]

1.3 Upper gastro‐intestinal bleed

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

0.2 [0.01, 3.92]

1.4 Wound infection

1

40

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.07, 14.90]

2 Autologous blood donation versus control Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

2.1 Bile leak

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.75]

2.2 Intra‐abdominal bleeding

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.01, 7.75]

3 Haemodilution versus control Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Bile leak

1

78

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.27, 8.49]

3.2 Intra‐abdominal bleeding

2

208

Risk Ratio (M‐H, Fixed, 95% CI)

1.87 [0.40, 8.67]

3.3 Intra‐abdominal infection

1

78

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.04, 3.07]

3.4 Intra‐abdominal collection requiring drainage

1

130

Risk Ratio (M‐H, Fixed, 95% CI)

1.26 [0.61, 2.60]

3.5 Wound infection

2

208

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.34, 2.03]

3.6 Chest infection

1

78

Risk Ratio (M‐H, Fixed, 95% CI)

1.5 [0.27, 8.49]

4 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Liver failure

1

12

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.15, 61.74]

4.2 Re‐operation

1

12

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.02, 6.86]

4.3 Hyperamylasemia

1

12

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.15, 61.74]

4.4 Atelectasis

1

12

Risk Ratio (M‐H, Fixed, 95% CI)

3.0 [0.15, 61.74]

5 Hypoventilation versus control Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Bile leak

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

4.10 [0.48, 35.10]

5.2 Cholangitis

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

3.08 [0.13, 73.27]

5.3 Thrombosis

1

79

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.07, 15.83]
Figuras y tablas -
Comparison 2. Peri‐operative morbidity
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Comparison 3. Bilirubin (micromol/litre)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Low CVP versus control Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 POD 1

2

90

Mean Difference (IV, Fixed, 95% CI)

0.22 [‐10.31, 10.75]

1.2 POD 3

2

90

Mean Difference (IV, Fixed, 95% CI)

2.02 [‐9.90, 13.94]

1.3 POD 7

2

90

Mean Difference (IV, Fixed, 95% CI)

5.02 [‐5.05, 15.09]
Figuras y tablas -
Comparison 3. Bilirubin (micromol/litre)
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Comparison 4. Prothrombin activity

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Low CVP versus control Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 POD 1

1

40

Mean Difference (IV, Fixed, 95% CI)

‐2.0 [‐10.00, 6.00]

1.2 POD 3

1

40

Mean Difference (IV, Fixed, 95% CI)

2.0 [‐5.17, 9.17]

1.3 POD 7

1

40

Mean Difference (IV, Fixed, 95% CI)

‐9.0 [‐33.48, 15.48]

2 Haemodilution with bovine haemoglobin (HBOC‐201) versus haemodilution with hydroxy ethyl starch (HES) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 POD 1

1

12

Mean Difference (IV, Fixed, 95% CI)

6.0 [‐9.29, 21.29]

2.2 POD 3

1

12

Mean Difference (IV, Fixed, 95% CI)

8.0 [‐24.26, 40.26]

2.3 POD 7

1

12

Mean Difference (IV, Fixed, 95% CI)

24.0 [‐5.38, 53.38]
Figuras y tablas -
Comparison 4. Prothrombin activity
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Comparison 5. Aspartate transaminase (international units/litre)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Low CVP versus control Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 POD 1

1

40

Mean Difference (IV, Fixed, 95% CI)

50.0 [‐18.40, 118.40]

1.2 POD 3

1

40

Mean Difference (IV, Fixed, 95% CI)

14.0 [‐47.39, 75.39]

1.3 POD 7

1

40

Mean Difference (IV, Fixed, 95% CI)

9.0 [‐15.48, 33.48]

2 Hypoventilation versus control Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 POD 1

1

79

Mean Difference (IV, Fixed, 95% CI)

‐5.00 [‐31.26, 17.26]
Figuras y tablas -
Comparison 5. Aspartate transaminase (international units/litre)
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Comparison 6. Alanine transaminase (international units/litre)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Low CVP versus control Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 POD 1

2

90

Mean Difference (IV, Fixed, 95% CI)

54.72 [7.89, 101.56]

1.2 POD 3

2

90

Mean Difference (IV, Fixed, 95% CI)

22.05 [‐31.05, 75.14]

1.3 POD 7

2

90

Mean Difference (IV, Fixed, 95% CI)

‐8.95 [‐49.61, 31.71]
Figuras y tablas -
Comparison 6. Alanine transaminase (international units/litre)
Ir a la tabla de la revisión