Targeted Control of Pulse Pressure Variation Versus Central Venous Pressure on Reduction of Intraoperative Blood Loss During Hepatic Resection

Abstract

In liver resection, central venous pressure (CVP) was used conventionally as a method of volume status evaluation, and low CVP technique (≤ 5 mmHg) was used to reduce blood loss since the 1990s. In recent years, CVP was regarded as a static indicator to assess intravascular volume status. Pulse pressure variation (PPV) is a preload index that can be used to predict an individual’s fluid responsiveness through an existing arterial line. The purpose of this study was to determine if PPV is as safe and effective as CVP as a guide for fluid management during hepatic resection. Between February 2018 and June 2019 total 50 patients who met inclusion and exclusion criteria were randomized to PPV targeted group (group A) or CVP targeted group (group B). In both groups, central venous catheter and arterial line were inserted. Fluid was restricted at 2ml/kg/hr starting before induction of anaesthesia. Nitroglycerine was started with 0.5 ug/kg/min and titrated to achieve targeted values of PPV (13-18%) in group A and CVP (2-5 mmHg) in group B

    Similar works