Low central venous pressure with milrinone during living donor hepatectomy.
Maintaining a low central venous pressure (CVP) has been frequently used in liver resections to reduce blood loss. However, decreased preload carries potential risks such as hemodynamic instability. We hypothesized that a low CVP with milrinone would provide a better surgical environment and hemodynamic stability during living donor hepatectomy. Thirty-eight healthy adult liver donors were randomized to receive either milrinone (milrinone group, n = 19) or normal saline (control group, n = 19) infusion during liver resection. The surgical field was assessed using a four-point scale. Intraoperative vital signs, blood loss, the use of vasopressors and diuretics and postoperative laboratory data were compared between groups. The milrinone group showed a superior surgical field (p < 0.001) and less blood loss (142 +/- 129 mL vs. 378 +/- 167 mL, p < 0.001). Vital signs were well maintained in both groups but the milrinone group required smaller amounts of vasopressors and less-frequent diuretics to maintain a low CVP. The milrinone group also showed a more rapid recovery pattern after surgery. Milrinone-induced low CVP improves the surgical field with less blood loss during living donor hepatectomy and also has favorable effects on intraoperative hemodynamics and postoperative recovery.
Ryu
H-G
HG
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
Nahm
F S
FS
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
Sohn
H-M
HM
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
Jeong
E-J
EJ
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
Jung
C-W
CW
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
D001794:Blood Pressure / Q000187:drug effects*; D006498:Hepatectomy; D006801:Humans; D019520:Living Donors; D020105:Milrinone / Q000494:pharmacology / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*
D014665:Vasodilator Agents; D020105:Milrinone