Association between central venous pressure and blood loss during hepatic resection in 984 living donors.
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.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kyk@amc.seoul.kr
Y K
YK
Kim
J H
JH
Chin
S J
SJ
Kang
I G
IG
Jun
J G
JG
Song
S M
SM
Jeong
J Y
JY
Park
G S
GS
Hwang
D000328:Adult; D000758:Anesthesia; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D001835:Body Weight; D002496:Central Venous Pressure / Q000502:physiology*; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D004809:Ephedrine / Q000627:therapeutic use; D005234:Fatty Liver / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000601:surgery*; D019520:Living Donors; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D014662:Vasoconstrictor Agents; D004809:Ephedrine