간엽 절제술시 중심정맥압이 출혈량에 미치는 영향

Abstract

Background Some studies reported that lowering central venous pressure (LCVP) during liver resection could significantly reduce the intra-operative blood loss, however it is still controversial concerning LCVP induced renal dysfunction, hypovolemia, hemodynamic instability. This study evaluated the association of low central venous pressure with blood loss during liver resection comparing the control group.

Methods A total 62 patients aged 20 to 70 underwent hepatectomy by the same group of surgeon were randomized into group L (CVP < 10 mmHg, n = 30) and control group C (CVP > 10 mmHg, n = 32) during dissection and lobectomy period. Data such as age, sex, concurrent disease, liver resection site (right or left), pre-, intra- and postoperative day 3 hemoglobin, blood urea nitrogen, creatinine, bleeding time, prothrombin time, activated partitial thromboplastin time, intraoperative blood loss, urine output, transfusion volume, length of hospital stay were collected and compared between the two groups and t-test was used for comparison of results.

Results The difference of total blood loss between two groups was 193.6 ± 432.2 ml (group L; 589.1 ± 380.8 ml, group C; 782.7 ± 316.7 ml), however statistically insignificant (P value = 0.1243). Additionally, there were no significant differences in other data including the length of hospital stay.

Conclusions Our results suggest maintaining CVP under 10 mmHg is not effective in reducing blood loss during liver resection.