Central Venous Pressure and Its Effect on Blood Loss during Hepatic Lobectomy.

Choi,  Seung Ho; Ban,  So Young; Jun,  Na Hyung; Jun,  Dong Byeong; Nam,  Soon Ho; Kil,  Hae Keum; Kim,  Kyung Sik

doi:2007.52.6.663

Randomized Controlled Trial

Korean Journal of Anesthesiology 2007;52(6):663-668.
DOI: https://doi.org/10.4097/kjae.2007.52.6.663

Central Venous Pressure and Its Effect on Blood Loss during Hepatic Lobectomy.

Seung Ho Choi, So Young Ban, Na Hyung Jun, Dong Byeong Jun, Soon Ho Nam, Hae Keum Kil, Kyung Sik Kim

¹Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. nsh66@yumc.yonsei.ac.kr
²Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
³Department of General Surgery, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Some studies reported that lowering central venous pressure (LCVP) during liver resection could significantly reduce the intra-operative blood loss, however it is still controversial concerning LCVP induced renal dysfunction, hypovolemia, hemodynamic instability. This study evaluated the association of low central venous pressure with blood loss during liver resection comparing the control group. METHODS: A total 62 patients aged 20 to 70 underwent hepatectomy by the same group of surgeon were randomized into group L (CVP < 10 mmHg, n = 30) and control group C (CVP > 10 mmHg, n = 32) during dissection and lobectomy period. Data such as age, sex, concurrent disease, liver resection site (right or left), pre-, intra- and postoperative day 3 hemoglobin, blood urea nitrogen, creatinine, bleeding time, prothrombin time, activated partitial thromboplastin time, intraoperative blood loss, urine output, transfusion volume, length of hospital stay were collected and compared between the two groups and t-test was used for comparison of results. RESULTS: The difference of total blood loss between two groups was 193.6 +/- 432.2 ml (group L; 589.1 +/- 380.8 ml, group C; 782.7 +/- 316.7 ml), however statistically insignificant (P value = 0.1243). Additionally, there were no significant differences in other data including the length of hospital stay. CONCLUSIONS: Our results suggest maintaining CVP under 10 mmHg is not effective in reducing blood loss during liver resection.

Key Words: blood loss; central venuos pressure; hepatic lobectomy