title: Effects of clamping procedures on central venous pressure during liver resection.
abstract: BACKGROUND
  Various clamping procedures are used to decrease bleeding during liver resections but their effect on central venous pressure (CVP) remains unclear. The aim of this study was to assess the variations of the CVP during two different clamping procedures.
  
  
  METHODS
  We retrospectively reviewed 29 patients (19 males, 10 females) who had Pringle maneuver (PM) and clamping of the inferior vena cava below the liver (IVCC) during major liver resections.
  
  
  RESULTS
  Mean decrease of the CVP after PM, IVCC, and PM+IVCC was 0.84 ± 1.37, 2.17 ± 2.13 and 3.17 ± 2.56 cmH20, respectively (P=0.02, P<0.0001 and P<0.0001, respectively). IVCC was more effective in inducing a decrease of the CVP than PM alone (P<0.05). The combination of both PM and IVCC induced the greatest decrease but not to a level of significance compared to IVCC alone (P=0.25).
  
  
  CONCLUSIONS
  IVCC remains the more efficient procedure to lower the CVP. However, although PM is commonly used to control vascular inflow within the liver its significant influence on the CVP could participate to the reduction of bleeding during liver resections.
authors.affiliation: Department of digestive and hepatobiliary surgery, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Gagnière
authors.affiliation: Department of digestive and hepatobiliary surgery, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: B
authors.initials: B
authors.lastname: Le Roy
authors.affiliation: Department of digestive and hepatobiliary surgery, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: O
authors.initials: O
authors.lastname: Antomarchi
authors.affiliation: Department of biostatistics (DRCI), CHU de Clermont-Ferrand, place Henri-Dunant, 63000 Clermont-Ferrand, France.
authors.forename: B
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Department of anesthesia, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France.
authors.forename: E
authors.initials: E
authors.lastname: Futier
authors.affiliation: Department of digestive and hepatobiliary surgery, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France; Department of oncologic surgery, Léon-Bérard Cancer Center, 69000 Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Dupré
authors.affiliation: Department of digestive and hepatobiliary surgery, hôpital Estaing, CHU de Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France. Electronic address: ebuc@chu-clermontferrand.fr.
authors.forename: E
authors.initials: E
authors.lastname: Buc
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D002496:Central Venous Pressure; D003250:Constriction; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D012189:Retrospective Studies; D014682:Vena Cava, Inferior / Q000601:surgery*
keywords: Bleeding; Central venous pressure; Inflow; Liver resection; Outflow; Pringle