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

• Published in: Acta anaesthesiologica Scandinavica Vol. 53; no. 5; pp. 601 - 606
• Main Authors: KIM, Y. K., CHIN, J. H., KANG, S. J., JUN, I. G., SONG, J. G., JEONG, S. M., PARK, J. Y., HWANG, G. S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2009; Blackwell
• Subjects: Adult; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Loss, Surgical - statistics & numerical data; Body Weight; Central Venous Pressure - physiology; Cohort Studies; Data Interpretation, Statistical; Ephedrine - therapeutic use; Fatty Liver - pathology; Female; Hepatectomy; Humans; Liver - surgery; Living Donors; Logistic Models; Male; Medical sciences; Retrospective Studies; Sex Factors; Vasoconstrictor Agents - therapeutic use; Anesthesia; Central venous pressure; Living donor; Liver; Blood loss
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2009.01920.x

Background: Although low central venous pressure (CVP) anesthesia has been used to minimize blood loss during hepatectomy, the efficacy of this technique remains controversial. We therefore assessed the association between blood loss and CVP during hepatic resection, and examined significant determinants associated with intraoperative hemorrhage during hepatectomy in living donors. Methods: Between April 2004 and April 2008, 984 living donors who underwent a hepatic resection were assessed retrospectively. Univariate and multivariate analyses were performed to explore the relationships between intraoperative blood loss and several variables including CVP. Results: The mean intraoperative blood loss was 691.3 ± 365.5 ml. Only four donors required packed red blood cell transfusions (mean, 1.5 U). The mean duration of hepatic resection was 92.1 ± 26.3 min. The mean, maximum, and minimum values of CVP measured during hepatectomy were 4.6 ± 1.7, 5.3 ± 1.8, and 4.0 ± 1.8 mmHg, respectively, and were not significantly correlated with intraoperative blood loss. On multivariate analysis, predictors of hemorrhage were liver fatty change, gender, and body weight, but none of the mean CVP, surgeons, anesthesiologists, anesthesia duration, resected liver volume, hepatectomy type, systolic blood pressure, heart rate, or body temperature were significant. Conclusions: 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.