[Influence of Pringle maneuver used in children during hepatic tumors resections on fluid resuscitation and intraoperative blood loss].
Partial vascular exclusion (Pringle maneuver) is one of the methods diminishing risk of massive intraoperative blood loss. Effects of Pringle maneuver were deeply explored in adults due to big series of operated patients but experiences with Pringle maneuver in children are very limited. The aim of the study was to estimate usefulness of Pringle maneuver in the limitation of intraoperative blood loss and the amount of intraoperative fluid therapy necessary during liver resections in children.


METHODS
The group of 70 children operated because of liver tumors during the period of 20 years were studied. Patients were divided into 2 subgroups. Group I consisted of 35 patients without Pringle maneuver during liver resection. Group II was consisted of 35 children operated with Pringle maneuver. In all patients intraoperative diuresis and hemodynamic parameters of blood circulation were monitored and the blood loss and fluid therapy were assessed.


RESULTS
In group I operated on without Pringle maneuver statistically significant higher amount of blood transfusions were indicated and in group II statistically significant higher amount of colloids were indicated.


CONCLUSIONS
The results achieved documented that introduction of Pringle maneuver during liver resection in children allow to achieve statistically significant limitation of blood loss during operation but hemodynamic disorders during partial vascular exclusion (Pringle maneuver) requires transfusion of higher amounts of volume colloid fluids.
Kaźmirczuk
Roman
R
Department of Anesthesiology and Intensive Therapy, Nicolaus Copernicus University, Toruń, Collegium Medicum of Bydgoszcz, Poland. kazmirczuk@wp.pl
Kusza
Krzysztof
K
Prokurat
Andrzej
A
Chrupek
Małgorzata
M
Laniewski-Wołłk
Przemysław
P
Byszewski
Andrzej
A
Kaliciński
Piotr
P
D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D005440:Fluid Therapy; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D019194:Ischemic Preconditioning / Q000379:methods*; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000601:surgery*
Wpływ manewru Pringle'a zastosowanego u dzieci podczas resekcji guzów watroby na terapie płynowa i śródoperacyjna utrate krwi.