• Javier Ripollés, Ángel Espinosa, Rubén Casans, Ana Tirado, Alfredo Abad, Cristina Fernández, and José Calvo.
• Anestesia e Reanimação, Hospital Universitário Infanta Leonor, Madri, Espanha. Electronic address: ripo542@gmail.com.
• Rev Bras Anestesiol. 2015 Jul 1;65(4):281-91.

IntroductionSeveral clinical trials on Goal directed fluid therapy (GDFT) were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to kidney failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids, in GDFT, to determine complications and mortality associated associated.MethodsA bibliographic research was carried out in Medline, Pubmed, Embase and Cochrane Library, corroborating randomized clinical trials in those crystalloids are compared to colloids in GDFT for mayor non-cardiac surgery in adults.ResultsOne hundred thirty references were found, among those 38 were selected, and 29 analyzed; of these, 6 were included for systematic review and meta-analysis, including 390 patients. It was perceived that the use of colloids it not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% IC] 3.87 [1.121, 13, 38]); I(2)=0.0%; p=0.635).ConclusionesDue to this meta-analysis' limitations for small number of randomized clinical trials and patients included, the results should be taken cautiously, and it is proposed to carry out new randomized clinical trials, with enough statistical power, comparing balanced and non-balanced colloids to balanced and non-balanced crystalloids, following the protocols of GDFT, respecting current guidelines and suggestions made by groups of experts.Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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