Association between central venous pressure and blood loss during hepatic resection in 984 living donors

Kim, Young‐Kug; Chin, Ji Hyun; Kang, Sung-Hwa; Jun, In‐Gu; Song, Jae-Kwan; Jeong, Sung Moon; Park, Jong Yeon; Hwang, Gyu‐Sam

doi:10.1111/j.1399-6576.2009.01920.x

Cited by 61 publications

(49 citation statements)

References 17 publications

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“…Low CVP during liver resection is thought to reflect low hepatic sinusoid pressure, reducing parenchymal congestion. To date, however, maintaining low CVP during hepatectomy to reduce blood loss is controversial, especially in healthy living donors [1,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Effect of stroke volume variation‐directed fluid management on blood loss during living‐donor right hepatectomy: a randomised controlled study

et al. 2015

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Summary Reducing blood loss is beneficial in living liver donor hepatectomy. Although it has been suggested that maintaining a low central venous pressure is important, it is known that low stroke volume variation may be associated with increased blood loss. Therefore, we compared the effect on blood loss of 40 patients randomly assigned to a high stroke volume variation group (maintaining 10–20% of stroke volume variation) vs 38 patients in a control group (maintaining < 10% stroke volume variation) during living‐donor right hepatectomy. Mean (SD) blood loss during donor hepatectomy was significantly lower in the high stroke volume variation group than in the control group: 476 (131) ml vs 836 (341) ml, respectively (p < 0.001). Blood pressure and peri‐operative laboratory values did not differ between the two groups. However, in the high stroke volume variation group, central venous pressure values were also significantly lower. We were unable to disentangle the effects of stroke volume variation and central venous pressure, but our results confirm that the two together appear beneficial.

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Section: Introductionmentioning

confidence: 99%

Effect of stroke volume variation‐directed fluid management on blood loss during living‐donor right hepatectomy: a randomised controlled study

et al. 2015

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“…13 Compared with previous studies, intraoperative transfusions were more frequently used in our study. 5,11,14 The discrepancy between our study and others may arise from the different definitions of intraoperative transfusion that were used. Previous studies have reported the frequency of whole blood or packed red blood cell transfusions as the intraoperative transfusion.…”

Section: Discussionmentioning

confidence: 42%

“…Ryu and associates 26 and Melendez and associates 27 have reported that a low central venous pressure may help minimize blood loss without adversely affecting organ perfusion during donor hepatectomy. In contrast to these findings, in a large series of 984 living donors, Kim and associates 11 showed no association between central venous pressure and intraoperative blood loss.…”

Section: Discussionmentioning

confidence: 58%

“…11,[26][27] In our study, the intraoperative mean central venous pressure measurements were not significantly different between patients with an intraoperative adverse event and those without such an adverse event. Ryu and associates 26 and Melendez and associates 27 have reported that a low central venous pressure may help minimize blood loss without adversely affecting organ perfusion during donor hepatectomy.…”

Section: Discussionmentioning

confidence: 62%

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Incidence and Risk Factors of Intraoperative Adverse Events During Donor Lobectomy for Living-Donor Liver Transplantation: A Retrospective Analysis

Araz¹,

Pirat²,

Unlukaplan³

et al. 2012

Exp Clin Transplant

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Results: Ninety-one patients (50%) had at least 1 intraoperative adverse event including hypothermia (39%), hypotension (26%), need for transfusions (17%), and hypertension (7%). Patients with an adverse event were older (P = .001), had a larger graft weight (P = .023), more frequently underwent a right hepatectomy (P = .019), and were more frequently classified as American Society of Anesthesiologists physical status class II (P = .027) than those who did not have these adverse events. Logistic regression analysis revealed that only age (95% confidence interval 1.018-1.099; P = .001) was a risk factor for intraoperative adverse events. Patients with these adverse events more frequently required admission to the intensive care unit and were hospitalized longer postoperatively. A before and after analysis showed that after introduction of in-line fluid warmers and more frequent use of acute normovolemic hemodilution, the frequency of intraoperative adverse events was significantly lower (80% vs 29%; P < .001). Conclusions:Intraoperative adverse events such as hypothermia and hypotension were common in living-donor liver transplant donors, and older age was associated with an increased risk of these adverse events. However, the effect of these adverse events on postoperative recovery is not clear.

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“…[11] Whereas retrospective reviews of living related donor hepatectomies have reported that CVP monitoring did not reduce blood loss, and that blood loss did not correlate with CVP level. [12,13,14] Reduced blood loss can be attributed to the fact that hepatic venous pressure is dependent on central venous pressure. Low CVP increases negative pressure gradient with respect to right atrium and increase in air embolism which can be detected by transechocardiography.…”

Section: Discussion:-mentioning

confidence: 99%

Hepatic Resection: a Challenge to Anaesthesiologist!!!

Arora¹,

Chhaya²,

Parikh.³

2017

IJAR

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Association between central venous pressure and blood loss during hepatic resection in 984 living donors

Abstract: CVP during hepatic resection was not associated with intraoperative blood loss in living liver donors, suggesting that CVP may not be an important factor in predicting blood loss during hepatectomy in healthy subjects.

Cited by 61 publications

References 17 publications

Effect of stroke volume variation‐directed fluid management on blood loss during living‐donor right hepatectomy: a randomised controlled study

Effect of stroke volume variation‐directed fluid management on blood loss during living‐donor right hepatectomy: a randomised controlled study

Incidence and Risk Factors of Intraoperative Adverse Events During Donor Lobectomy for Living-Donor Liver Transplantation: A Retrospective Analysis

Hepatic Resection: a Challenge to Anaesthesiologist!!!

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