Stroke Volume Variation in Hepatic Resection: A Replacement for Standard Central Venous Pressure Monitoring

Dunki-Jacobs, Erik M.; Philips, Prejesh; Scoggins, Charles R.; McMasters, Kelly M.; Martin, Robert C.G.

doi:10.1245/s10434-013-3323-9

Cited by 67 publications

(55 citation statements)

References 31 publications

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“…Both groups of donors did not receive any blood transfusion peri-operatively. No significant between-group difference was observed in median (IQR [range]) hospital stay after operation: 11 (10-13 [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]) days in the control vs 11 (10-13 [10][11][12][13][14][15][16][17][18][19][20]) days in the high SVV group, p = 0.621.…”

Section: Resultsmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

“…Stroke volume variation has been shown to predict fluid status in patients with diseased, but not normal, livers undergoing hepatic resection [13]. In addition, an SVV > 10% was able to predict fluid responsiveness with a sensitivity and specificity of 94% in liver transplant recipients [14].…”

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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“…A high SVV of 10% to 20% is associated with significantly less blood loss during liver resection. 4 Nonetheless a multiparametric approach should be adopted to guide fluid management in complicated cases because every haemodynamic variable has limitations and interferes with other variables.…”

Section: Discussionmentioning

confidence: 99%

Management of an incidental finding of right internal jugular vein agenesis

Kong

Jian

et al. 2017

Hong Kong Med J

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A 43-year-old woman was referred to the University of Hong Kong-Shenzhen Hospital in August 2016 with a 10-year history of hepatolithiasis. Computed tomography (CT) of the abdomen demonstrated multiple stones in the right posterior portion of the liver, the common biliary duct, and the gallbladder. Dilatation and inflammation of both intra-and extra-hepatic ducts were apparent and an elective right hepatectomy along with a Roux-en-Y hepaticojejunostomy was arranged. Preoperative physical examination was normal apart from hypertension (168/105 mm Hg). Laboratory tests revealed a microcytic, hypochromic anaemia (haemoglobin, 97 g/L), hyperuricaemia, and mildly elevated alkaline phosphatase. Liver/renal function, clotting profile, chest X-ray, and electrocardiogram were all normal. General anaesthesia was induced intravenously with propofol and remifentanil using a target-controlled infusion (Marsh model) under the guidance of the Bispectral Index monitoring system (Covidien, Boulder [CO], US). Tracheal intubation was performed following administration of rocuronium and anaesthesia maintained intravenously with intermittent positive pressure ventilation in oxygen and air. The patient was positioned for right internal jugular vein (IJV) cannulation.Pre-insertion sonographic evaluation of the right cervical region (SonoSite M-Turbo, Bothell [WA], US) using a linear, high-frequency transducer (HFL38, 6-13 MHz) revealed only a single pulsatile vessel that was non-compressible and suggestive of the right carotid artery. The characteristic pulsatile blood flow was confirmed by Doppler. There was no evidence of the right IJV despite repositioning of the patient's head, use of minimal pressure on the probe with colour flow mapping, and the application of Valsalva manoeuvre. Ultrasonography of the left side showed normal anatomy with good size of IJV. Following a brief discussion, the consultant anaesthetist and the surgeon decided to proceed with surgery without a central venous catheter. At the end of liver resection, the patient began to develop hypotension that was marginally responsive to fluid

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“…These new mini-invasive parameters that could replace PVC in the future are: stroke volume variation and change in systolic pressure. VVP and VPS respectively [25], also they have joined in this line of safety and better patient outcomes, better control for not achieving fluid overloads in time to replenish fluids. It seems clear today that hypervolemia generates pressure on the endothelial surface to damage the liver, affecting among other things the ability to impair the passage of liquids and neutrophils from one side to another extension.…”

Section: Minimally Invasive Hemodynamic Monitoringmentioning

confidence: 99%

Anesthesia in Liver Resections: Review

Bonofiglio

2017

JACCOA

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Stroke Volume Variation in Hepatic Resection: A Replacement for Standard Central Venous Pressure Monitoring

Cited by 67 publications

References 31 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

Management of an incidental finding of right internal jugular vein agenesis

Anesthesia in Liver Resections: Review

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