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.