CENTRAL VENOUS-PRESSURE AND ITS EFFECT ON BLOOD-LOSS DURING LIVER RESECTION

Citation
Rm. Jones et al., CENTRAL VENOUS-PRESSURE AND ITS EFFECT ON BLOOD-LOSS DURING LIVER RESECTION, British Journal of Surgery, 85(8), 1998, pp. 1058-1060
Citations number
15
Categorie Soggetti
Surgery
Journal title
ISSN journal
00071323
Volume
85
Issue
8
Year of publication
1998
Pages
1058 - 1060
Database
ISI
SICI code
0007-1323(1998)85:8<1058:CVAIEO>2.0.ZU;2-U
Abstract
Background Any strategy to reduce blood loss in liver resection and de crease blood transfusion would be of benefit to the patient and surgeo n. This study evaluates the association of central venous pressure (CV P) with blood loss and blood transfusion during liver resection. Metho ds One hundred consecutive hepatic resections in the period 1986-1996 were studied prospectively concerning CVP, volume of blood lost, and v olume of blood transfused. Blood loss volume and blood transfusion wer e analysed for these with a CVP less than or equal to 5 cmH(2)O and gr eater than 5 cmH(2)O. A multivariate analysis assessed potential confo unding factors in the comparison. Results The median blood loss in pat ients with a CVP of 5 cmH(2)O or less was 200 ml (n = 40) and that in those with a CVP above 5 cmH(2)O was 1000 ml (n = 52) (P = 0.0001). On ly two of 40 patients with a CVP of 5 cmH(2)O or less had a blood tran sfusion whereas 25 of 52 patients with a CVP greater than 5 cmH(2)O re quired a transfusion (P = 0.0008). A multivariate analysis did not sho w confounding factors. Conclusion The volume of blood lost during live r resection correlates with the CVP. Lowering the CVP to less than 5 c mH(2)O is a simple and effective way to reduce blood loss during liver surgery.