title: External jugular venous pressure as an alternative to conventional central venous pressure in right lobe donor hepatectomies.
abstract: OBJECTIVE
  Many centers have adopted central vein cannulation both for central venous pressure monitoring and fluid administration for right hepatectomy in living-liver donors. However, use of central venous catheters is associated with adverse events that are hazardous to patients and expensive to treat. This study sought to examine the use of external jugular venous pressure as an alternative to conventional central venous pressure in right lobe donor hepatectomies
  
  
  METHODS
  Forty ASA grade I adult living liver-donors without a known history of significant cardiac or pulmonary diseases were enrolled in this prospective observational study. Paired measurement of venous pressures (external jugular venous pressure and internal jugular venous pressure) were taken at the following times: after induction of anesthesia, 30 minutes after skin incision, during right lobe mobilization (every 15 minutes), during hepatic transaction (every 15 minutes), after right lobe resection (every 15 minutes), and after abdominal closure.
  
  
  RESULTS
  Paired measurements were equal in 47.5%, 53.5%, 61.5%, 46.3%, and 52.5% for after induction, after skin incision, right lobe mobilization, right lobe transection, after resection, and before abdominal closure periods. However, all measurements were within acceptable limits of bias measurements (± 2 mm Hg).
  
  
  CONCLUSIONS
  Central venous pressure catheter placement can be avoided and replaced by a less-invasive method such as external jugular venous pressure (which gave an acceptable estimate of central venous pressure in all phases of right lobe resection) in living-donor liver transplant and allowed equivalent monitor even during fluid restriction phases.
authors.affiliation: National Liver Institute, Menofeya University, Egypt. dabdullah@liver-eg.org
authors.forename: Mohamed Hussein
authors.initials: MH
authors.lastname: Abdullah
authors.forename: Hossam El Deen
authors.initials: Hel D
authors.lastname: Soliman
authors.forename: Wessam Saber
authors.initials: WS
authors.lastname: Morad
mesh_terms: D000328:Adult; D001795:Blood Pressure Determination; D002405:Catheterization, Central Venous; D002496:Central Venous Pressure; D004534:Egypt; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007601:Jugular Veins / Q000503:physiopathology*; D016014:Linear Models; D016031:Liver Transplantation / Q000009:adverse effects; D019520:Living Donors; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult