title: Hemodynamics and oxygen transport dynamics during hepatic resection at different central venous pressures in a pig model.
abstract: BACKGROUND
  Although low central venous pressure (CVP) has been used to minimize blood loss during hepatectomy, the impact of variations of CVP on the rate of blood loss and on the perfusion of end-organs has not been evaluated. This animal study aimed to evaluate the hemodynamics and oxygen transport changes during hepatic resection at different CVP levels.
  
  
  METHODS
  Forty-eight anesthetized Bama miniature pigs were divided into 8 groups with CVP during hepatic resection controlled at 0 to <1, 1 to <2, 2 to <3, 3 to <4, 4 to <5, 5 to <6, 6 to <7, and 7 to <8 cmH2O. Intergroup comparisons were made for hemodynamic parameters, oxygen transport dynamics, and the rate of blood loss.
  
  
  RESULTS
  The rate of blood loss and the hepatic venous pressure during hepatic resection were almost linearly related to the CVP. A significant drop in the mean arterial pressure, cardiac output, and cardiac index occurred between CVP ≥2 and <2 cmH2O. Oxygen delivery (DO2), oxygen consumption (VO2) and oxygen extraction ratio (ERO2) remained relatively constant between CVPs of 2 to <8 cmH2O. There was a significant drop in DO2 when the CVP was <2 cmH2O. There was also a significant drop in VO2 and ExO2 when the CVP was <1 cmH2O.
  
  
  CONCLUSIONS
  The optimal CVP for hepatic resection is 2 to 3 cmH2O.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Guangxi Medical University, Nanning 530021, China. guoya2000@medmail.com.cn
authors.forename: Ya
authors.initials: Y
authors.lastname: Guo
authors.forename: Cheng-Xin
authors.initials: CX
authors.lastname: Lin
authors.forename: Wan-Yee
authors.initials: WY
authors.lastname: Lau
authors.forename: Di
authors.initials: D
authors.lastname: Long
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Lao
authors.forename: Zhang
authors.initials: Z
authors.lastname: Wen
authors.forename: Eric Ch
authors.initials: ECh
authors.lastname: Lai
authors.forename: Xi-Jun
authors.initials: XJ
authors.lastname: Wang
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
authors.forename: Xiao
authors.initials: X
authors.lastname: Qing
mesh_terms: D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001921:Brain / Q000378:metabolism; D002496:Central Venous Pressure; D005260:Female; D006439:Hemodynamics; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D023421:Models, Animal; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors
chemical_list: D010100:Oxygen