Effect of stroke volume variation‐directed fluid management on blood loss during living‐donor right hepatectomy: a randomised controlled study

Choi, Seong-Soo; Jun, In Gu; Cho, S.-S.; Kim, S.-K.; Hwang, Gyo Seung; Kim, Y.-K.

doi:10.1111/anae.13155

Cited by 21 publications

(25 citation statements)

References 34 publications

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“…1). During the period of this study, 2 reports were presented regarding high SVV management during liver transection in livingdonor right hepatectomy set at 10%-20%, 19,20 but there has been no report of management with SVV as an indicator in conventional open-liver resection for liver diseases. In this study, to achieve the target SVV, we mainly addressed fluid restriction only.…”

Section: Discussionmentioning

confidence: 99%

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

Kitaguchi

Gotohda

Yamamoto

et al. 2018

International Surgery

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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

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Section: Discussionmentioning

confidence: 99%

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

Kitaguchi

Gotohda

Yamamoto

et al. 2018

International Surgery

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“…The utility of SVV in guiding intraoperative fluid administration has been reported in many clinical contexts, such as in hepatic and neurosurgical surgeries. 10 , 22 , 23 Importantly, our group has previously suggested that maintaining a high SVV is a useful way to reduce blood loss during living donor right hepatectomy. 10 , 11 , 24 Additionally, a higher SVV value has been reported to correlate with a lower right ventricular end-diastolic volume index value in liver transplant recipients.…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 22 , 23 Importantly, our group has previously suggested that maintaining a high SVV is a useful way to reduce blood loss during living donor right hepatectomy. 10 , 11 , 24 Additionally, a higher SVV value has been reported to correlate with a lower right ventricular end-diastolic volume index value in liver transplant recipients. 12 The maintenance of a high SVV appears to induce lower normal levels of intravascular volume and to thereby prevent vascular congestion.…”

Section: Discussionmentioning

confidence: 99%

“… 8 , 9 Recently, our group found that blood loss during living donor hepatectomy was significantly lower in donors who maintained 10-20% of stroke volume variation (SVV) compared with those who maintained <10% of SVV. 10 , 11 However, no study has yet reported the relationship between the high SVV method (i.e. maintaining 10-20% of SVV during surgery) and intraoperative blood transfusion in liver transplant recipients, who are frequently at risk for blood transfusion during liver transplantation.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Stroke Volume Variation and Blood Transfusion during Liver Transplantation

Choi¹,

Lee²,

Yoo³

et al. 2016

Int. J. Med. Sci.

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Background. Intraoperative blood transfusion increases the risk for perioperative mortality and morbidity in liver transplant recipients. A high stroke volume variation (SVV) method has been proposed to reduce blood loss during living donor hepatectomy. Herein, we investigated whether maintaining high SVV could reduce the need for blood transfusion and also evaluated the effect of the high SVV method on postoperative outcomes in liver transplant recipients.Methods. We retrospectively analyzed 332 patients who underwent liver transplantation, divided into control (maintaining <10% of SVV during surgery) and high SVV (maintaining 10-20% of SVV during surgery) groups. We evaluated the blood transfusion requirement and hemodynamic parameters, including SVV, as well as postoperative outcomes, such as incidences of acute kidney injury, durations of postoperative intensive care unit and hospital stay, and rates of 1-year mortality.Results. Mean SVV values were 7.0% ± 1.3% in the control group (n = 288) and 11.2% ± 1.8% in the high SVV group (n = 44). The median numbers of transfused packed red blood cells and fresh frozen plasmas in the high SVV group were significantly lower than those in control group (0 vs. 2 units, P = 0.003; and 0 vs. 3 units, P = 0.033, respectively). No significant between-group differences were observed for postoperative outcomes.Conclusions. Maintaining high SVV can reduce the blood transfusion requirement during liver transplantation without worsening postoperative outcomes. These findings provide insights into improving perioperative management in liver transplant recipients.

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“…The first prospective report by Jones et al [15] stated that maintaining a low CVP is a widely used method to minimize intraoperative blood loss [16,17], CVP is believed to reflect the hepatic sinusoid pressure, rendering it an effective indicator for reducing hepatic parenchymal congestion, thus reducing blood loss and controlling hepatic venous hemorrhage [18], it is well known that a target CVP during hepatic resection is 5 mmHg or lower has shown significant reduction of bleeding, morbidity and mortality [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Internal jugular vein distensibility in assessment of fluid responsiveness in donors of living donor liver transplantation

Abdou

Ammar

2018

Egyptian Journal of Anaesthesia

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Background: The concept of brain death is still not acceptable nor implemented in Egypt. Donor safety in liver transplantation is on the top of our priorities. Purpose: The purpose of this study is to evaluate the effectiveness of using IJV distensibility as a reliable method for intraoperative assessment of fluid responsiveness. Methods: A prospective observational study was conducted in Ain Shams university specialized hospitals. 40 donor candidates for right lobe hepatectomy for living donor liver transplantation were enrolled. During period of hypovolemia (T0) left IJV scanned and measured. After a given fluid bolus in the form of ringer acetate 5 ml/ kg. ultrasonic and hemodynamic measurements were reassessed 10 min (T 10) after the fluid resuscitation. Results: Highly significant changes in MABP, HR, and CVP (p < 0.01) were detected after fluid resuscitation, regarding the IJV distensibility it showed a highly significant reduction from baseline (T0) to post-resuscitation expansion (P = 0.0001). Baseline (T0) measurements showed no significant correlation between IJV distensibility and hemodynamic parameters (P ≥ 0.05). Post-resuscitation values (T10) showed no significance correlation between HR and IJV distensibility (P = 0.772). On the other side it showed a highly significance negative correlation between MABP, CVP and IJV distensibility (r = −0.390, P = 0.013) and (r = −0.332 * , p = 0.036) respectively. The correlation between the percentages of change of IJV distensibility and hemodynamic parameters showed highly significant negative correlation between IJV distensibility and MABP (r = −0.359, P = 0.023) also with CVP (r = −0.464, P = 0.017). No difference was found regarding the HR (P = 0.336). Conclusion: Organ transplantation centers with experience, CVP monitoring may not be necessary in highly selective patient population. IJV distensibility, a non-invasive and safe method can be used to guide fluid replacement in healthy donor.

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Effect of stroke volume variation‐directed fluid management on blood loss during living‐donor right hepatectomy: a randomised controlled study

Cited by 21 publications

References 34 publications

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

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

Relationship between Stroke Volume Variation and Blood Transfusion during Liver Transplantation

Internal jugular vein distensibility in assessment of fluid responsiveness in donors of living donor liver transplantation

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