title: Controlled low central venous pressure reduces blood loss and transfusion requirements in hepatectomy.
abstract: OBJECTIVE
  To evaluate the effect of low central venous pressure (LCVP) on blood loss and blood transfusion in patients undergoing hepatectomy.
  
  
  METHODS
  Electronic databases and bibliography lists were searched for potential articles. A meta-analysis of all randomized controlled trials (RCTs) investigating LCVP in hepatectomy was performed. The following three outcomes were analyzed: blood loss, blood transfusion and duration of operation.
  
  
  RESULTS
  Five RCTs including 283 patients were assessed. Meta-analysis showed that blood loss in the LCVP group was significantly less than that in the control group (MD = -391.95, 95%CI: -559.35--224.56, P < 0.00001). In addition, blood transfusion in the LCVP group was also significantly less than that in the control group (MD = -246.87, 95%CI: -427.06--66.69, P = 0.007). The duration of operation in the LCVP group was significantly shorter than that in the control group (MD = -18.89, 95%CI: -35.18--2.59, P = 0.02). Most studies found no significant difference in renal and liver function between the two groups.
  
  
  CONCLUSIONS
  Controlled LCVP is a simple and effective technique to reduce blood loss and blood transfusion during liver resection, and appears to have no detrimental effects on liver and renal function.
authors.affiliation: Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Li
authors.affiliation: Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Sun
authors.affiliation: Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
authors.forename: Fei-Xiang
authors.initials: FX
authors.lastname: Wu
authors.affiliation: Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Yang
authors.affiliation: Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
authors.forename: Zhi-Jie
authors.initials: ZJ
authors.lastname: Lu
authors.affiliation: Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Yu
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D002496:Central Venous Pressure; D016009:Chi-Square Distribution; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D016017:Odds Ratio; D061646:Operative Time; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Blood loss; Blood transfusion; Hepatectomy; Low central venous pressure