. 2023 Aug 12;12(16):5262. doi: 10.3390/jcm12165262

Table 1.

Designs of studies conducted with 6% HES 130/0.4 or 0.42.

Study	Trial Design/Country/ Type of Patients	Study Fluids	Indication and Dose (Planned, Maximal and Cumulative) of HES	Endpoints	Definition of Renal Endpoint
Septic patients
Perner, 2009–2011, published in 2012 (6S) [40]	Prospective, multi-center, parallel, blinded, randomized Denmark, Norway, Finland and Iceland Severe sepsis, septic shock	6% (130/0.42) HES–398 patients Ringer’s acetate–400 patients	Indication: volumen expansion Planned: 33 mL/kg daily Daily maximal: 50 mL/kg (exceeded only in case of two patients) Cumulative: 44 mL/kg (IQR: 24–75 mL/kg) (~3168 mL/patients)	Primary: composite (death or dependence on dialysis) at 90 days Secondary: ○ the development of AKI ○ percentages of days alive without RRT	Use of RRT, or A renal SOFA score ≥ 3, or Plasma creatinine level > 179 μmol/L or urinary output < 500 mL/d Doubling of the plasma creatinine level
Müller, 2015 [86]	Post-hoc analysis of 6S trial [9] Denmark, Norway, Finland and Iceland Severe sepsis, septic shock	6% (130/0.42) HES–398 patients Ringer’s acetate–400 patients	Indication: volumen expansion Planned: 33 mL/kg daily Daily maximal: 50 mL/kg) (exceeded only in case of two patients) Cumulative: 44 mL/kg (IQR: 24–75 mL/kg) (~3168 mL/patients)	Daily average AKI stage Trajectories of the AKI stages Hazard risk of increasing or decreasing AKI stage Time to initiation of RRT Intervention effect on mortality for AKI Effect of increasing AKI stage on mortality	KDIGO Missing baseline creatinine values were estimated using MDRD formula
Dubin, 2010 [93]	Prospective, bi-center, randomized, controlled, pilot trial Two centers in Argentina Severe sepsis	6% (130/0.4) HES–9 patients 0.9% saline–11 patients	Indication: intravenous volume expansion to increase microvascular flow index (MFI) Planned: unknown Daily maximal: unknown Cumulative: unknown	Sublingual microcirculatory parameters Fluid balance	Creatinine (baseline and at 24 h) Urine output
Guidet, 2012 (CRYSTMAS) [41]	Prospective, multi-center, double-blind, randomized, active-controlled 24 centers in France and Germany Severe sepsis	6% (130/0.42) HES–100 patients 0.9% saline–96 patients	Indication: (initial) hemodynamic stabilization Planned: unknown Fluid intake prior randomization: 35.5 ± 25.3 mL/kg) Daily maximal: 50 mL × kg⁻¹ × d⁻¹ on the first day; 25 mL × kg⁻¹ × d⁻¹ from the second to the fourth day Cumulative: 1379 ± 886 mL, 2615 ± 1499 mL over four consecutive days	Primary: the amount of study drug required to achieve initial hemodynamic stabilization at the end of first four hours Secondary: ○ time taken to achieve initial hemodynamic stabilization, ○ total quantity of study drug infused over four consecutive days in the intensive care unit	RIFLE AKIN ARF: a two-fold increase in serum creatinine from baseline or need for renal replacement therapy NAG NGAL α1-microglobulin
Myburgh, 2012 (CHEST) [38,39]	Prospective, multi-center, parallel, blinded, randomized, controlled 32 centers in Australia and New Zealand Hypovolemic patients at any time in the ICU	6% (130/0.42) HES–3315 patients 0.9% saline–3336 patients	Indication: correction of hypovolemia Planned: unknown Daily maximal: unknown. Daily dose: 526 ± 425 mL (~6.6 ± 5.3 mL/kg) Cumulative: unknown	Primary: all-cause mortality at 90 days, Secondary: ○ incidence of AKI ○ the use of RRT ○ new organ failures for cardiovascular, respiratory, coagulation and liver systems	RIFLE
Annane, 2013 (CRISTAL) [84]	Prospective, multi-center, parallel, randomized 57 centers in France, Belgium, Canada, Algeria and Tunisia Sepsis, multiple trauma, hypovolemic shock	Crystalloid infusions–1443 patients (isotonic saline, hypertonic saline, buffered solutions) Colloid–1414 patients (hypooncotic (eg. gelatines, 4% or 5% of albumin), hyperoncotic (eg. dextrans, hydroxy-ethyl starches and 20% or 25% of albumin)	Indication: fluid resuscitation Planned: unknown Daily maximal: 30 mL/kg Cumulative: 1500 mL (95% CI: 1000–2000 mL), (~21.4 mL/kg [14.3–28.6 mL/kg]) 973 patients (68.8%), duration 2 (95% CI: 1–2) days	Primary: mortality at 28 days Secondary: ○ death rates at 90 days and at ICU and hospital discharge, ○ number of days alive and not receiving RRT, mechanical ventilation or vasopressor therapy ○ days without organ system failure (i.e., SOFA score < 6), days not in the ICU or hospital for 28 days from ICU admission	Need of renal replacement therapy (indications were not presented)
Cardiac surgery patients
Gallandat 2000 [50]	Prospective, multi-center, parallel, randomized, double-blind, clinical, phase III study Two centers in the Netherlands Coronary artery bypass surgery	6% (130/0.42) HES in saline–30 patients 6% (200/0.5) HES–29 patients	Indication: acute normovolemic hemodilution + priming the heart-lung machine + intra/postoperative fluid management Planned: 500 mL for hemodilution, 1000 mL for priming the heart-lung machine Daily maximal: 3000 mL (~36.1 mL/kg) Cumulative: intraoperatively: 1475 ± 100 mL (~17.8 mL/kg), postoperatively: 1150 ± 511 mL (~13.9 mL/kg), total: 2550 ± 561 mL (31.0 ± 7.4 mL/kg) in 130/0.4 HES group	Primary: compare the total volume of colloids (HES plus isotonic pasteurized plasma) infused per treatment group from induction of anesthesia until 16 h after the end of surgery Secondary: ○ hemodynamics, ○ blood gases, ○ fluid balance	Urine output Serum creatinine
Van der Linden, 2005 [52]	Prospective, single-center, single-blind, randomized, open controlled noninferiority study regarding ○ hemodynamics ○ fluid balance ○ coagulation parameters ○ serum creatinine ○ liver enzymes Belgium Coronary artery bypass surgery	6% (130/0.4) HES–64 patients modified fluid gelatine–68 patients	Indication: priming the heart-lung machine + postoperative fluid management Planned: not reported Daily maximal: 50 mL × kg⁻¹ × d⁻¹ Cumulative: 21.3 ± 8.3 mL/kg (~1683 ± 656 mL) intraoperatively, 27.5 ± 12.6 mL/kg (~2173 ± 995 mL) postoperatively, 48.9 ± 17.2 mL/kg (~3863 ± 1359 mL) total	Hemodynamic data Fluid balance Laboratory data	Serum creatinine Urine production
Ooi, 2009 [72]	Prospective, single-center, single-blind, randomized, controlled Malaysia Coronary artery bypass surgery	6% (130/0.4) HES–45 patients succinylated gelatine–45 patients	Indication: priming the heart-lung machine + intra/postoperative fluid management Planned: not reported Daily maximal: 50 mL × kg⁻¹ × d⁻¹ Cumulative: intraoperatively: 1225.6 ± 158.3 mL (~17.5 mL/kg), first 24 h postoperatively: 716.7 ± 910.2 mL (~10.2 mL/kg), total: 1942.3 ± 1046.1 mL (27.7 mL/kg) in HES group	Primary: postoperative blood loss Secondary: ○ transfusion of blood products ○ total volume of colloids infused per treatment group intraoperatively and in the first 24h postoperatively ○ renal function ○ complications related to colloid usage	eGFR based on MDRD formula
Skhirtladze, 2014 [94]	Prospective, single-center, randomized, controlled, double-blind trial Austria Elective cardiovascular surgery [i.e., CABG, valve repair or replacement and surgery of the ascending aorta] on cardiopulmonary bypass	HA group: 5% albumin up to 50 mL × kg⁻¹ × day⁻¹–76 patients HES group: 6% HES 130/0.4 up to 50 mL × kg⁻¹ × day⁻¹–81 patients RL group: RL up to 50 mL × kg⁻¹ × day⁻¹–79 patients	Indication: priming the heart-lung machine + intra/postoperative fluid management Planned: 1500 mL for priming, intraoperative dose was restricted to 33 mL × kg⁻¹ × d⁻¹ Daily maximal: 50 mL × kg⁻¹ × d⁻¹ Cumulative: intraoperatively: 2500 (IQR: 2250–2750) mL, postoperatively: 625 (IQR: 50–1000) mL, total: 3000 (IQR: 2750–3500) mL in HES group	Primary: clinical bleeding based on chest tube drainage over the first 24 h after cardiopulmonary bypass Secondary: ○ serum creatinine ○ transfusion of PRBCs and other blood products ○ changes in hemoglobin and hemostatic parameters	Renal dysfunction defined as serum creatinine 1.5 mg/dL Delta creatinine (maximal creatinine value within 48 h minus baseline creatinine)
Joosten, 2016 [77]	Prospective, single-center, parallel, double-blinded, randomized, controlled Belgium Elective cardiovascular surgery on cardiopulmonary bypass (CPB)	6% (130/0.4) maize HES–59 patients 6% (130/0.42) potato HES–59 patients	Indication: priming the heart-lung machine + intra/postoperative fluid management Planned: 1000 mL for priming (~13 mL/kg), intraoperative dose in 250 mL boluses to maintain SVV <13% Daily maximal: 50 mL × kg⁻¹ × d⁻¹ Cumulative: intraoperatively: 1000 mL (IQR: 000–1250 mL) (~13 [IQR: 13–16 mL/kg]) in maize and 1000 mL (IQR: 1000–1200 mL) (~13 [IQR: 13–16 mL/kg]) in potato HES (NS); up to POD2: 1950 mL (IQR: 1250–2325 mL) (~25 [IQR: 16–29 mL/kg]) mL in maize HES and 2000 mL (IQR: 1500–2700 mL) (~27 [IQR: 20–66 mL/kg]) mL in potato HES (NS)	Primary: Calculated blood loss up to POD2 Secondary: ○ short and long-term effects of study fluids on postoperative renal function	Short-term: AKIN and requirement of RRT Long-term: urea, creatinine, eGFR (CKD-EPI formula)
Svendsen, 2018 [91]	Prospective, single-center, randomized, controlled study, blinded for all participating investigators except for the perfusionist Norway Coronary artery bypass surgery	6% (130/0.42) HES–20 patients Ringer’s acetate–20 patients	Indication: priming the heart-lung machine Planned: 1700 mL for priming Daily maximal: unknown Cumulative: unknown	Fluid balance Hemoglobin, hematocrit, platelets, coagulation parameters (TEG)	AKIN
Duncan, 2020 [69]	Prospective, single-center, randomized, controlled, triple-blind, parallel-group, non-inferiority study USA Scheduled aortic valve replacement	6% (130/0.42) HES–69 patients 5% human albumin–72 patients	Indication: hypovolemia Planned: 250 or 500 mL boluses if hypovolemia detected by monitoring of cardiac index, HR, systolic blood pressure, vasopressor requirement and CVP/PCWP or in case of severe acute surgical haemorrhage Daily maximal: 35 mL × kg⁻¹ × day⁻¹ Cumulative: unknown	Primary: urinary NGAL at baseline, 1 h after arrival to ICU and 24 h after completion of surgery Secondary: ○ changes in hemostatic parameters ○ urinary IL-18 ○ all-cause one-year mortality ○ kidney function at 6 and 12 months	RIFLE and see also Endpoints
Postoperative patients after abdominal surgery
Mahmood 2007 [63]	Prospective, single-center, randomized Denmark, Norway, Finland and Iceland Severe sepsis, septic shock	6% 200/0.62 HES–21 patients 6% 130/0.4 HES–21 patients 4% gelatine–20 patients	Indication: maintenance infusion during and after the surgery Planned: 3 mL/kg bolus of colloid followed by a maintenance rate of 2 mL × kg⁻¹ × h⁻¹ during surgery and increased to maintain a urine output greater than 0.5 mL × kg⁻¹ × h⁻¹. Further colloid administration was based on maintenance of MAP over 85 mmHg and CVP between 8 and 10 cmH₂O Daily maximal: 3911 ± 1783 mL (~51 ± 23 mL/kg) in 130/0.4 HES group Cumulative: from 8 h before surgery to 24 h after the surgery: 3443 ± 1769 mL (~45 ± 23 mL/kg) in 200/0.62 HES group 3911 ± 1783 mL (~51 ± 23 mL/kg) in 130/0.4 HES group	Serum creatinine BUN Urinary IgG:creatinine ratio α1-microglobulin:creatinine ratio	See Endpoints
Godet, 2008 [70]	Prospective, multi-center, parallel, open, randomized, controlled Seven centers in France Postoperative patients after abdominal aortic surgery	6% (130/0.42) HES in saline–29 patients 3% modified fluid gelatine–31 patients	Indication: maintenance infusion during and after the surgery Planned: according to anesthesiologist’s judgement during surgery based on MAP, CVP, fluid balance and the need of catecholamines Daily maximal: 50 mL × kg⁻¹ × d⁻¹ Cumulative: Day 1: 1709 ± 836 mL (23.9 ± 11.9 mL/kg) Day 2: 1577 ± 714 mL (21.8 ± 9.5 mL/kg) Day 3: 1780 ± 752 mL (24.8 ± 10.5 mL/kg) Day 4: 1862 ± 1171 mL (25.4 ± 15.4 mL/kg) Day 5: 1874 ± 1308 mL (26.2 ± 17.7 mL/kg) Day 6: 1779 ± 1204 mL (24.0 ± 16.2 mL/kg) Total (day 1– day 6): 10 237 ± 4561 mL (139.7 ± 58.2 mL/kg)	Primary renal safety parameter: the peak increase in serum creatinine up to POD6 or hospital discharge Secondary: ○ renal dysfunction defined as serum creatinine above the upper limit of normal plus an increase of ≥44.2 mmol/L (≥0.5 mg/dL) above baseline at any time point after the end of surgery ○ the minimum postoperative CrCl ○ the incidence of oliguria (urine output < 500 mL/day) ○ urinary NAG	CrCl: ○ mild (≥50 mL/min) ○ moderate (30–50 mL/min) ○ severe (<30 mL/min)
Mukhtar 2009 [64]	Prospective, single-center, randomized Egypt Patients scheduled for living donor liver transplantation	6% 130/0.4 HES–20 patients 5% albumin–20 patients	Indication: maintenance infusion during and after the surgery Planned: 250 mL bolus based on maintenance of CVP and/or PAOP between 5 and 7 cmH₂O Daily maximal: 50 mL × kg⁻¹ × d⁻¹ during the intraoperative period and first 4 postoperative days Cumulative: intraoperatively: 3080 ± 417 mL, postoperatively: 6229 ± 1140 mL in 130/0.4 HES group	AKI Duration of postoperative mechanical ventilation Start of enteral feeding Pulmonary complications	Creatinine clearance Cystatin C
Yang 2011 [53]	Prospective, single-center, randomized China Hepatectomy	6% (130/0.4) HES–30 patients 20% human-albumin–30 patients Ringer’s lactate–30 patients	Indication: maintenance infusion during and after the surgery Planned: 1000 mL/d (~16 mL/kg) in POD1–3 and 500 mL/d (~8 mL/kg) on POD4–5 Daily maximal: unknown Cumulative: intraoperatively: 3484.6 ± 1072.5 mL (~56 ± 17 mL/kg), total: 10,235.0 ± 393.9 mL (~165 ± 6 mL/kg) in 130/0.4 HES group	Child–Turcotte–Pugh grading MELD score C-reactive protein, IL-6 Pulmonary complications Nosocomial infections Bleeding In-hospital mortality	BUN Creatinine
Demir, 2015 [92]	Prospective, multi-center, randomized Turkey Living-donor liver transplantation	6% (130/0.4) HES–18 patients 4% gelatine–18 patients	Indication: maintenance infusion during the surgery Planned: according to hemodynamic data (SVV, CVP, MAP) Daily maximal: unknown Cumulative: 2.3 ± 0.8 L (~32 ± 11 mL/kg) in 130/0.4 HES group	Renal endpoints	BUN, Creatinine (eGFR: Cockroft-Gault, MDRD, CKD-EPI)
Ghodraty, 2017 [74]	Prospective, bi-center, parallel, double-blinded, randomized, controlled Iran, USA Small intestine resection	6% (130/0.4) HES–46 patients Ringer’s lactate–45 patients	Indication: maintenance infusion during the surgery Planned: 2 mL × kg⁻¹ × h⁻¹ as a maintenance fluid plus fluid loss in 1:1 ratio Daily maximal: unknown Cumulative: 10.4 ± 4.1 mL/kg	Primary: the time of the first flatus or bowel movement Secondary: ○ AKI ○ surgical complications	AKIN
Joosten, 2018 [83]	Prospective, bi-center, parallel, double-blinded, randomized, controlled, superiority trial Two centers in Belgium Scheduled open abdominal surgery (patients required unexpected suprarenal aortic crossclamping were excluded)	6% (130/0.4) waxy maize HES in balanced crystalloids–80 patients balanced crystalloids–80 patients	Indication: maintenance infusion during the surgery Planned: EGDT (multiple 100-mL mini-fluid challenges) based on hemodynamic measurements (SVV; closed-loop system) Daily maximal: 33 mL/kg Cumulative: 900 mL (IQR: 400–1300 mL) (~13 mL/kg [IQR: 6–18 mL/kg]) intraoperatively. Only one patient (1%) reached the maximal dose	Primary: POMS score at POD2 Secondary: ○ the effect of study fluids on postoperative renal function ○ cardiac, pulmonary, gastrointestinal, renal, infectious complications ○ coagulation ○ surgical complications up to 30 days after surgery	KDIGO Requirement of RRT
Kammerer, 2018 [95]	Prospective, single-center, parallel, single-blinded Germany Scheduled for cystectomy	6% (130/0.4) HES–47 patients 5% human-albumin–53 patients	Indication: replacement of blood loss in 1:1 ratio during the surgery, postoperative fluid management Planned: replacement of blood loss in 1:1 ratio during the surgery, postoperative fluid management Daily maximal: 30 mL/kg Cumulative: 2000 ± 969 mL (~27 ± 13 mL/kg)	Primary: serum cystatin C ratio between POD 90 and preoperative values Secondary: ○ eGFR ○ NGAL ○ RIFLE on POD 3 and POD 90 ○ change of serum cystatin C levels ○ need for vasopressors and catecholamines up to POD 3	Serum cystatin C RIFLE
Werner, 2018 [89]	Prospective, multi-center, parallel, double-blinded, randomized Three tertiery care centers Germany	balanced 10% HES 130/0.42–20 patients balanced 6% HES 130/0.42–22 patients balanced crystalloid–21 patients	Indication: intraoperative fluid management Planned: EGDT (multiple 100-mL mini-fluid challenges) based on hemodynamic measurements (SVV) Daily maximal: 30 mL/kg for 10% HES; 50 mL/kg for 6% HES Cumulative: 2250 (IQR: 1750–3000 mL); 33.3 mL/kg (IQR: 28.2–46.2 mL/kg for 6% HES)	Primary: the intraoperative volume of HES Secondary: ○ AKI ○ fluid balances ○ hemodynamics	KDIGO (as post-hoc analysis)
Kabon, 2019 [78]	Prospective, multi-center, parallel, double-blinded, randomized One center in Austria, two centers in USA Postoperative patients after major abdominal surgery (open or laparoscopically assisted)	6% HES 130/0.4 in 0.9% saline–523 patients Ringer’s lactate–534 patients	Indication: intraoperative volume replacement Planned: 250 mL over 5 min based on esophageal Doppler measurements (stroke volume, corrected aortic flow time) Daily maximal: 1500 mL Cumulative: 1 (IQR: 0.5–1.5) liter	Primary: a composite of major complications (cardiac, pulmonary, infectious, gastrointestinal, renal, coagulation) Secondary: a composite of minor complications the primary composite augmented by readmission and mortality Safety: ○ in-hospital serum creatinine concentrations ○ serum creatinine concentration up to 6 months postoperatively	Maximum postoperative serum creatinine concentration (stages 1–3 of AKI are not clearly defined)
Futier, 2020 (FLASH) [73]	Prospective, multi-center, double-blind, parallel, randomized 20 university hospitals in France Postoperative patients after major abdominal surgery	6% HES 130/0.4 in 0.9% saline–389 patients 0.9% saline–386 patients	Indication: intraoperative volume replacement Planned: 250 mL over 5 min to maximize stroke volume; in case of less than a 10% increase in stroke volume, the study fluid administration was stopped Daily maximal: 30 mL × kg⁻¹ × d⁻¹ (100 patients [10.5%] of patients received more) Cumulative: intraoperatively: 1000 mL (IQR: 750–1500 mL) (~12 mL/kg [IQR: 9–18 mL/kg]); postoperatively: 500 mL (IQR: 500–750 mL) (~6 mL/kg [IQR: 6–9 mL/kg]); POD2: 500 mL (IQR: 250–1000 mL) (~6 mL/kg [IQR: 3–14 mL/kg]); total: 33.4 ± 3.4 mL/kg in HES group (~2739 ± 279 mL)	Primary: a composite of mortality or at least one of the following by POD14: AKI, pulmonary, cardiovascular, infectious or surgical complication Secondary: ○ major postoperative complications to POD14. ○ kidney dysfunction: oliguria (24-h urine output < 500 mL), KDIGO score ○ major adverse cardiovascular events ○ pulmonary complications ○ SIRS score on POD2 ○ SOFA score without GCS on POD2 ○ time to return of bowel function (flatus and stool)	KDIGO
Others
Neff 2003 [65]	Prospective, single-center, randomized, controlled Switzerland Craniocerebral trauma	6% (130/0.42) HES–16 patients 6% (200/0.5) HES + 5% albumin–15 patients	Indication: volume replacement in the ICU for up to 28 days Planned: repetitive large doses Daily maximal: 70 mL × kg⁻¹ × d⁻¹ Cumulative: 2297 ± 610 mL (~30 ± 8 mL/kg) daily; total: 19 ± 16 L (~246 ± 208 mL/kg) (max: 66 L!) 20 mL × kg⁻¹ × day⁻¹: n = 16, mean duration: 4.8 days 30 mL × kg⁻¹ × day⁻¹: n = 16, mean duration: 3.9 days 40 mL × kg⁻¹ × day⁻¹: n = 13, mean duration: 3.1 days 50 mL × kg⁻¹ × day⁻¹: n = 12, mean duration: 2.0 days 60 mL × kg⁻¹ × day⁻¹: n = 10, mean duration: 1.8 days 70 mL × kg⁻¹ × day⁻¹: n = 3, mean duration: 1.0 day	Safety of HES 6% (130/0.4) with regard to coagulation and renal function	Not specified
James, 2011 (FIRST) [58]	Prospective, single-center, double-blind, randomized, controlled USA Penetrating and blunt trauma	6% (130/0.42) HES–36 patients with penetrating, 20 patients with blunt trauma 0.9% saline–31 patients with penetrating, 22 patients with blunt trauma	Indication: fluid resuscitation Planned: undetermined Daily maximal: 33 mL × kg⁻¹ × d⁻¹ Cumulative: Penetrating trauma: 5093 ± 2733 mL (~70 ± 38 mL/kg); Blunt trauma: 6113 ± 1919 mL (~79 ± 25 mL/kg)	Primary: volume of resuscitation fluid in the first 24 h, tolerance of full enteral feeding by POD5 Secondary: ○ use of blood product ○ biochemical abnormalities, particularly lactate, chloride, and acid–base and hemostatic disturbances ○ SOFA scores Safety: ○ AKI	RIFLE
Tyagi 2019 [80]	Prospective, single-center, double-blind, randomized, controlled India Scheduled orthopedic surgery under general anesthesia with >200–300 mL blood loss expected	6% (130/0.42) HES–19 patients Ringer’s lactate–19 patients	Indication: intraoperative fluid replacement Planned: If SVV was >10% in supine or lateral position, or >14% in prone position, a bolus of 100 mL of the intervention fluid was infused over 2–4 min Daily maximal: not applicable Cumulative: 689 ± 394 mL (~12 ± 7 mL/kg)	AKI NGAL Urine output The volume of intervention fluid Blood loss	KDIGO NGAL

Abbreviations: AKI: Acute Kidney Injury; AKIN: Acute Kidney Injury Network; ARF: Acute Renal Failure; BUN: Blood Urea Nitrogen; CI: Confidential Interval; CPB: Cardiopulmonary Bypass; CrCl: Creatinine Clearance; CVP: Central Venous Pressure; EGDT: Early Goal Directed Therapy; eGFR: estimated Glomerular Filtration Rate; GCS: Glasgow Coma Scale; HA: Human Albumin; HES: Hydroxyethyl Starch; ICU: Intensive Care Unit; IgG: Immunglobulin G; IQR: Interquartile Range; KDIGO: Kidney Disease: Improving Global Outcome; MAP: Mean Arterial Pressure; MDRD: Modification of Diet in Renal Disease; MELD: Model of End-Stage Liver Disease; NAG: β-N-Acetyl-β-D-Glucosaminidase; NGAL: Neutrophil Gelatinase-Associated Lipocalin; PAOP: Pulmonary Arterial Occlusion Pressure; POD: Postoperative Day; POMS: Profile of Mood States; RIFLE: Risk, Injury, Failure, Loss, End-stage renal disease criteria for acute kidney injury; RL: Ringer’s Lactate; RRT: Renal Replacement Therapy; SIRS: Systemic Inflammatory Response Syndrome; SOFA: Sepsis-related Organ Failure Assessment; SVV: Stroke Volume Variation.