What Is the Preferred Central Venous Pressure Zero Reference for Hepatic Resection?

Giordano, Chris; Deitte, Lori A.; Gravenstein, Nikolaus; Rice, Mark J.

doi:10.1213/ane.0b013e3181c76d3e

Cited by 13 publications

(4 citation statements)

References 30 publications

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“…All patients had a central line with the central venous pressure (CVP) maintained as low as possible during anesthesia. [35][36][37] Liver transection was accomplished using the Kelly-crush technique with portal inflow clamping (the Pringle maneuver) at the surgeons' discretion. Transfusion of blood products (red blood cells, fresh frozen plasma, platelets, or cryoprecipitate) was guided by a standardized restrictive protocol.…”

Section: Interventionsmentioning

confidence: 99%

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Karanicolas

Lin

Tarshis

et al. 2016

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Section: Interventionsmentioning

confidence: 99%

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Karanicolas

Lin

Tarshis

et al. 2016

HPB

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“…The positioning of the pressure transducer is an important consideration in the interpretation of CVP because the relationship between the CVP transducer and the operative site will change depending on the segmental location of the resection and the physical dimensions of the liver 16 …”

Section: Discussionmentioning

confidence: 99%

Factors in perioperative care that determine blood loss in liver surgery

McNally

Revie

Massie

et al. 2012

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This study confirms a relationship between CVP and blood loss in hepatic resection. Intraoperative CVP values were higher than those described in other studies. There was variation in the intraoperative management of patients. Collaboration between surgical and anaesthesia teams is required to minimize blood loss and the standardization of intraoperative anaesthesia practice may improve outcomes following liver surgery.

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“…Use of topical haemostatic agents is documented. All patients will have their CVP maintained as low as possible during anaesthesia, as is routinely performed during liver resection 13 47 48. Intraoperative crystalloid and colloid fluids will be managed by the anaesthesiologist based on their usual practice.…”

Section: Methods and Analysismentioning

confidence: 99%

Tranexamic acid versus placebo to reduce perioperative blood transfusion in patients undergoing liver resection: protocol for the haemorrhage during liver resection tranexamic acid (HeLiX) randomised controlled trial

et al. 2022

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IntroductionDespite use of operative and non-operative interventions to reduce blood loss during liver resection, 20%–40% of patients receive a perioperative blood transfusion. Extensive intraoperative blood loss is a major risk factor for postoperative morbidity and mortality and receipt of blood transfusion is associated with serious risks including an association with long-term cancer recurrence and overall survival. In addition, blood products are scarce and associated with appreciable expense; decreasing blood transfusion requirements would therefore have health system benefits. Tranexamic acid (TXA), an antifibrinolytic, has been shown to reduce the probability of receiving a blood transfusion by one-third for patients undergoing cardiac or orthopaedic surgery. However, its applicability in liver resection has not been widely researched.Methods and analysisThis protocol describes a prospective, blinded, randomised controlled trial being conducted at 10 sites in Canada and 1 in the USA. 1230 eligible and consenting participants will be randomised to one of two parallel groups: experimental (2 g of intravenous TXA) or placebo (saline) administered intraoperatively. The primary endpoint is receipt of blood transfusion within 7 days of surgery. Secondary outcomes include blood loss, postoperative complications, quality of life and 5-year disease-free and overall survival.Ethics and disseminationThis trial has been approved by the research ethics boards at participating centres and Health Canada (parent control number 177992) and is currently enrolling participants. All participants will provide written informed consent. Results will be distributed widely through local and international meetings, presentation, publication and ClinicalTrials.gov.Trial registration numberNCT02261415.

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What Is the Preferred Central Venous Pressure Zero Reference for Hepatic Resection?

Cited by 13 publications

References 30 publications

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Major liver resection, systemic fibrinolytic activity, and the impact of tranexamic acid

Factors in perioperative care that determine blood loss in liver surgery

Tranexamic acid versus placebo to reduce perioperative blood transfusion in patients undergoing liver resection: protocol for the haemorrhage during liver resection tranexamic acid (HeLiX) randomised controlled trial

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