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Comparison of absolute fluid restriction versus relative volume redistribution strategy in low central venous pressure anesthesia in liver resection surgery: a randomized controlled trial

Identifikátory výsledku

  • Kód výsledku v IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11140%2F17%3A10362384" target="_blank" >RIV/00216208:11140/17:10362384 - isvavai.cz</a>

  • Nalezeny alternativní kódy

    RIV/00669806:_____/17:10362384

  • Výsledek na webu

    <a href="https://www.minervamedica.it/it/riviste/minerva-anestesiologica/articolo.php?cod=R02Y9999N00A17041902" target="_blank" >https://www.minervamedica.it/it/riviste/minerva-anestesiologica/articolo.php?cod=R02Y9999N00A17041902</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.23736/S0375-9393.17.11824-9" target="_blank" >10.23736/S0375-9393.17.11824-9</a>

Alternativní jazyky

  • Jazyk výsledku

    angličtina

  • Název v původním jazyce

    Comparison of absolute fluid restriction versus relative volume redistribution strategy in low central venous pressure anesthesia in liver resection surgery: a randomized controlled trial

  • Popis výsledku v původním jazyce

    BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17). The ease of reaching low CVP, blood loss, morbidity and mortality were assessed. Besides, the effect of Pringle maneuver and utility of stroke volume variation (SVV) were analyzed. RESULTS: Both methods of CVP reduction were equally effective (0.7 +- 0.9 vs. 0.9 +- 1. protocolized steps in the AR and RR group; p=0.356) and safe (no difference in observed blood loss, intraoperative hemodynamic parameters, lactate levels, morbidity and mortality). Patients in the AR group received smaller amount of fluids in the pre-resection period (120 (100-150) vs. 600 (500-700) ml; p&lt;0.001), and had slightly longer hospital stay (10 (8-14) vs. 8 (7-11); p=0.045). Low CVP was predicted by SVV&gt;10% with 81.4% sensitivity and 77.1% specificity. Reduced blood loss and transfusion rate was observed when Pringle maneuver was used. CONCLUSIONS: In our study, absolute fluid restriction and relative volume redistribution seemed to be equally effective and safe methods of lowering CVP in patients undergoing liver resection. According to our data high SVV might be considered as a low CVP replacement. Pringle maneuver reduced blood loss and transfusion requirement.

  • Název v anglickém jazyce

    Comparison of absolute fluid restriction versus relative volume redistribution strategy in low central venous pressure anesthesia in liver resection surgery: a randomized controlled trial

  • Popis výsledku anglicky

    BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17). The ease of reaching low CVP, blood loss, morbidity and mortality were assessed. Besides, the effect of Pringle maneuver and utility of stroke volume variation (SVV) were analyzed. RESULTS: Both methods of CVP reduction were equally effective (0.7 +- 0.9 vs. 0.9 +- 1. protocolized steps in the AR and RR group; p=0.356) and safe (no difference in observed blood loss, intraoperative hemodynamic parameters, lactate levels, morbidity and mortality). Patients in the AR group received smaller amount of fluids in the pre-resection period (120 (100-150) vs. 600 (500-700) ml; p&lt;0.001), and had slightly longer hospital stay (10 (8-14) vs. 8 (7-11); p=0.045). Low CVP was predicted by SVV&gt;10% with 81.4% sensitivity and 77.1% specificity. Reduced blood loss and transfusion rate was observed when Pringle maneuver was used. CONCLUSIONS: In our study, absolute fluid restriction and relative volume redistribution seemed to be equally effective and safe methods of lowering CVP in patients undergoing liver resection. According to our data high SVV might be considered as a low CVP replacement. Pringle maneuver reduced blood loss and transfusion requirement.

Klasifikace

  • Druh

    J<sub>imp</sub> - Článek v periodiku v databázi Web of Science

  • CEP obor

  • OECD FORD obor

    30223 - Anaesthesiology

Návaznosti výsledku

  • Projekt

  • Návaznosti

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Ostatní

  • Rok uplatnění

    2017

  • Kód důvěrnosti údajů

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Údaje specifické pro druh výsledku

  • Název periodika

    Minerva Anestesiologica

  • ISSN

    0375-9393

  • e-ISSN

  • Svazek periodika

    83

  • Číslo periodika v rámci svazku

    10

  • Stát vydavatele periodika

    IT - Italská republika

  • Počet stran výsledku

    10

  • Strana od-do

    1051-1060

  • Kód UT WoS článku

    000413243400009

  • EID výsledku v databázi Scopus

    2-s2.0-85032453179