Central Venous Pressure Drop After Hypovolemic Phlebotomy is a Strong Independent Predictor of Intraoperative Blood Loss During Liver Resection
| Autor: | I. Parmentier, Franky Vansteenkiste, Mathieu D'Hondt, Claudine Christiaens, Andries Ryckx, Pieter Jan Steelant, Gregory Sergeant, Mathias Clarysse, Hans Pottel |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Central Venous Pressure medicine.medical_treatment Hypovolemia Blood Loss Surgical Renal function Blood volume 030230 surgery Kidney Function Tests Resection Young Adult 03 medical and health sciences 0302 clinical medicine Phlebotomy Blood loss Hepatectomy Humans Medicine Postoperative Period Aged Retrospective Studies Aged 80 and over Blood Volume business.industry Central venous pressure Retrospective cohort study Middle Aged Surgery Oncology Creatinine 030220 oncology & carcinogenesis Anesthesia Preoperative Period Female business |
| Zdroj: | Annals of Surgical Oncology. 24:1367-1375 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-016-5737-7 |
| Popis: | Intraoperative hypovolemic phlebotomy (HP) has been suggested to reduce central venous pressure (CVP) before hepatectomy. This study aimed to analyze the impact of CVP drop after HP on intraoperative blood loss and postoperative renal function. A retrospective review of a prospective database including 100 consecutive patients (43 males and 57 females; mean age, 65 years; range 23–89 years) undergoing liver resection with HP was performed. The primary outcome variable was estimated blood loss (EBL), and the secondary outcome was postoperative serum creatinin (Scr). A multivariate linear regression analysis was performed to identify predictors of intraoperative blood loss. The median CVP before blood salvage was 8 mmHg (range 4–30 mmHg). The median volume of hypovolemic phlebotomy was 400 ml (range 200–1000 ml). After HP, CVP decreased to a median of 3 mmHg (range –2 to 16 mmHg), resulting in a median CVP drop of 5.5 mmHg (range 2–14 mmHg). The median EBL during liver resection was 165 ml (range 0–800 ml). The median preoperative serum creatinin (Scr) was 0.82 g/dl (range 0.5–1.74 g/dl), and the postoperative Scr on day 1 was 0.74 g/dl (range 0.44–1.68 g/dl). The CVP drop was associated with EBL (P |
| Databáze: | OpenAIRE |
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