open access

Vol 49, No 2 (2017)
Original and clinical articles
Published online: 2017-06-22
Submitted: 2016-08-30
Accepted: 2017-01-03
Get Citation

Global end-diastolic volume could be more appropiate to reduce intraoperative bleeding than central venous pressure during major liver transection

Francisco Javier Redondo, Dawid Padilla, Ruben Villazala, Pedro Villaeiro, Victor Baladron, Natalia Bejerano
DOI: 10.5603/AIT.2017.0030
·
Pubmed: 28643321
·
Anaesthesiol Intensive Ther 2017;49(2):100-105.

open access

Vol 49, No 2 (2017)
Original and clinical articles
Published online: 2017-06-22
Submitted: 2016-08-30
Accepted: 2017-01-03

Abstract

BACKGROUND: Central venous pressure often fails to identify the true value of cardiac preload. Our purpose is to investigate whether Global End-Diastolic Volume (GEDV) values can control hemodynamic parameters for the measurement of fluid volume, cardiac preload and blood loss during liver transection.

METHODS: This was a prospective clinical study that included patients undergoing liver resection. All patients were monitored by means of PiCCO technology and 222 hemodynamic measurements were performed in 74 patients. Fluid restriction was used. Transpulmonary thermodilutions were performed at different times of surgery, namely: 1. at the beginning of surgery; 2. before hepatectomy and after selective vascular exclusion (Time 1); 3. approximately half way through the liver transection (Time 2); and 4. after liver resection (Time 3).

RESULTS: One hundred and twenty-nine of the 222 GEDV values were decreased (prevalence of hypovolemia of 58.1%). However, twenty two of the 222 CVP values were decreased (prevalence of 10.8%). Sensitivity of CVP with regard to volume depletion (GEDV > 650 mL m-2) on the times (1, 2 and 3) were 16.28 (95% CI: 4.08–28.48), 18.18 (95% CI: 5.65–30.75) and 21.43 (95% CI: 7.83–35.03), respectively. There was no correlation between CVP and GEDV.

CONCLUSIONS: GEDV values may be more appropriate for monitoring cardiac preload during liver transection.

Abstract

BACKGROUND: Central venous pressure often fails to identify the true value of cardiac preload. Our purpose is to investigate whether Global End-Diastolic Volume (GEDV) values can control hemodynamic parameters for the measurement of fluid volume, cardiac preload and blood loss during liver transection.

METHODS: This was a prospective clinical study that included patients undergoing liver resection. All patients were monitored by means of PiCCO technology and 222 hemodynamic measurements were performed in 74 patients. Fluid restriction was used. Transpulmonary thermodilutions were performed at different times of surgery, namely: 1. at the beginning of surgery; 2. before hepatectomy and after selective vascular exclusion (Time 1); 3. approximately half way through the liver transection (Time 2); and 4. after liver resection (Time 3).

RESULTS: One hundred and twenty-nine of the 222 GEDV values were decreased (prevalence of hypovolemia of 58.1%). However, twenty two of the 222 CVP values were decreased (prevalence of 10.8%). Sensitivity of CVP with regard to volume depletion (GEDV > 650 mL m-2) on the times (1, 2 and 3) were 16.28 (95% CI: 4.08–28.48), 18.18 (95% CI: 5.65–30.75) and 21.43 (95% CI: 7.83–35.03), respectively. There was no correlation between CVP and GEDV.

CONCLUSIONS: GEDV values may be more appropriate for monitoring cardiac preload during liver transection.

Get Citation

Keywords

global end-diastolic volume; central venous pressure; preload; liver resection; hemodynamic monitoring

About this article
Title

Global end-diastolic volume could be more appropiate to reduce intraoperative bleeding than central venous pressure during major liver transection

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 2 (2017)

Pages

100-105

Published online

2017-06-22

DOI

10.5603/AIT.2017.0030

Pubmed

28643321

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(2):100-105.

Keywords

global end-diastolic volume
central venous pressure
preload
liver resection
hemodynamic monitoring

Authors

Francisco Javier Redondo
Dawid Padilla
Ruben Villazala
Pedro Villaeiro
Victor Baladron
Natalia Bejerano

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