A Comparative Study of Intraoperative Fluid Management Using Stroke Volume Variation in Liver Resection

Abstract

The aim of this study is to examine whether intraoperative fluid management with stroke volume variation (SVV) can achieve safe intravenous fluid restriction and contribute to decreasing intraoperative blood loss in liver surgery. Background: In liver surgery, maintaining the central venous pressure (CVP) at a low level is effective in decreasing intraoperative blood loss. Recently, several studies have suggested that SVV obtained using the FloTrac system demonstrated a better fluid responsiveness than CVP. Methods: We enrolled 30 patients undergoing liver resection since May 2015 in this prospective observational study, and we set the SVV target during liver transection at 13%-20% (SVV group). Forty-three cases of liver resection that we performed between January 2014 and March 2015 without using CVP or SVV were used as the Control group. We compared the 2 groups by using intraoperative blood loss as the primary endpoint. Results: There was no significant difference in patient characteristics between the 2 groups. The mean SVV during liver transection in the SVV group was 15.6 6 4.4%. The infusion

Enhanced recovery after surgery in liver resection: current concepts and controversies

“…Therefore, SVV has an advantage in patients undergoing laparoscopic resections where CVP loses its value. Kitaguchi et al [59] used SVV > 13%–20% and fluid restriction < 5 ml/kg/h during hepatic resection compared to a historical cohort and found a significant decrease in blood loss and transfusion rates. Ratti et al [60] conducted a randomized trial comparing fluid management guided by SVV or CVP in patients undergoing laparoscopic left lateral resection.…”