-
Something wrong with this record ?
Comparison of absolute fluid restriction versus relative volume redistribution strategy in low central venous pressure anesthesia in liver resection surgery: a randomized controlled trial
J. Zatloukal, R. Pradl, J. Kletecka, T. Skalicky, V. Liska, J. Benes,
Language English Country Italy
Document type Comparative Study, Journal Article, Randomized Controlled Trial
- MeSH
- Anesthesia methods MeSH
- Central Venous Pressure MeSH
- Hepatectomy * MeSH
- Blood Loss, Surgical prevention & control MeSH
- Middle Aged MeSH
- Humans MeSH
- Intraoperative Care methods MeSH
- Prospective Studies MeSH
- Fluid Therapy methods MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
BACKGROUNDː Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODSː Patients undergoing resections of two or more liver segments were equally randomized to absolute fluid restriction (AR, N.=17) or relative volume redistribution group (RR, N.=17). The ease of reaching low CVP, blood loss, morbidity and mortality were assessed. Besides, the effect of Pringle maneuver and utility of stroke volume variation (SVV) were analyzed. RESULTSː Both methods of CVP reduction were equally effective (0.7±0.9 vs. 0.9±1.0 protocolized steps in the AR and RR group; P=0.356) and safe (no difference in observed blood loss, intraoperative hemodynamic parameters, lactate levels, morbidity and mortality). Patients in the AR group received smaller amount of fluids in the pre-resection period (120 (100-150) vs. 600 (500-700) mL; P<0.001), and had slightly longer hospital stay (10 [8-14] vs. 8 [7-11]; P=0.045). Low CVP was predicted by SVV>10% with 81.4% sensitivity and 77.1% specificity. Reduced blood loss and transfusion rate was observed when Pringle maneuver was used. CONCLUSIONSː In our study, absolute fluid restriction and relative volume redistribution seemed to be equally effective and safe methods of lowering CVP in patients undergoing liver resection. According to our data high SVV might be considered as a low CVP replacement. Pringle maneuver reduced blood loss and transfusion requirement.
References provided by Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc19035615
- 003
- CZ-PrNML
- 005
- 20191011122333.0
- 007
- ta
- 008
- 191007s2017 it f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.23736/S0375-9393.17.11824-9 $2 doi
- 035 __
- $a (PubMed)28421732
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a it
- 100 1_
- $a Zatloukal, Jan $u Department of Anesthesiology and Intensive Care, Pilsen University Hospital, Faculty of Medicine, Charles University Prague, Pilsen, Czech Republic - zatloukalj@fnplzen.cz.
- 245 10
- $a Comparison of absolute fluid restriction versus relative volume redistribution strategy in low central venous pressure anesthesia in liver resection surgery: a randomized controlled trial / $c J. Zatloukal, R. Pradl, J. Kletecka, T. Skalicky, V. Liska, J. Benes,
- 520 9_
- $a BACKGROUNDː Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODSː Patients undergoing resections of two or more liver segments were equally randomized to absolute fluid restriction (AR, N.=17) or relative volume redistribution group (RR, N.=17). The ease of reaching low CVP, blood loss, morbidity and mortality were assessed. Besides, the effect of Pringle maneuver and utility of stroke volume variation (SVV) were analyzed. RESULTSː Both methods of CVP reduction were equally effective (0.7±0.9 vs. 0.9±1.0 protocolized steps in the AR and RR group; P=0.356) and safe (no difference in observed blood loss, intraoperative hemodynamic parameters, lactate levels, morbidity and mortality). Patients in the AR group received smaller amount of fluids in the pre-resection period (120 (100-150) vs. 600 (500-700) mL; P<0.001), and had slightly longer hospital stay (10 [8-14] vs. 8 [7-11]; P=0.045). Low CVP was predicted by SVV>10% with 81.4% sensitivity and 77.1% specificity. Reduced blood loss and transfusion rate was observed when Pringle maneuver was used. CONCLUSIONSː In our study, absolute fluid restriction and relative volume redistribution seemed to be equally effective and safe methods of lowering CVP in patients undergoing liver resection. According to our data high SVV might be considered as a low CVP replacement. Pringle maneuver reduced blood loss and transfusion requirement.
- 650 _2
- $a anestezie $x metody $7 D000758
- 650 _2
- $a krvácení při operaci $x prevence a kontrola $7 D016063
- 650 _2
- $a centrální žilní tlak $7 D002496
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a tekutinová terapie $x metody $7 D005440
- 650 12
- $a hepatektomie $7 D006498
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a peroperační péče $x metody $7 D007430
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 _2
- $a lidé středního věku $7 D008875
- 650 _2
- $a prospektivní studie $7 D011446
- 655 _2
- $a srovnávací studie $7 D003160
- 655 _2
- $a časopisecké články $7 D016428
- 655 _2
- $a randomizované kontrolované studie $7 D016449
- 700 1_
- $a Pradl, Richard $u Department of Anesthesiology and Intensive Care, Pilsen University Hospital, Faculty of Medicine, Charles University Prague, Pilsen, Czech Republic.
- 700 1_
- $a Kletecka, Jakub $u Department of Anesthesiology and Intensive Care, Pilsen University Hospital, Faculty of Medicine, Charles University Prague, Pilsen, Czech Republic.
- 700 1_
- $a Skalicky, Tomas $u Department of Surgery, Pilsen University Hospital, Faculty of Medicine, Charles University Prague, Pilsen, Czech Republic.
- 700 1_
- $a Liska, Vaclav $u Department of Surgery, Pilsen University Hospital, Faculty of Medicine, Charles University Prague, Pilsen, Czech Republic. Faculty of Medicine, Biomedical Center, Charles University Prague, Pilsen, Czech Republic.
- 700 1_
- $a Benes, Jan $u Department of Anesthesiology and Intensive Care, Pilsen University Hospital, Faculty of Medicine, Charles University Prague, Pilsen, Czech Republic. Faculty of Medicine, Biomedical Center, Charles University Prague, Pilsen, Czech Republic.
- 773 0_
- $w MED00003363 $t Minerva anestesiologica $x 1827-1596 $g Roč. 83, č. 10 (2017), s. 1051-1060
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/28421732 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y a $z 0
- 990 __
- $a 20191007 $b ABA008
- 991 __
- $a 20191011122753 $b ABA008
- 999 __
- $a ok $b bmc $g 1452275 $s 1074165
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2017 $b 83 $c 10 $d 1051-1060 $e 20170419 $i 1827-1596 $m Minerva anestesiologica $n Minerva Anestesiol $x MED00003363
- LZP __
- $a Pubmed-20191007
