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World J. Gastroenterol. · Jan 2014
Review Meta AnalysisControlled low central venous pressure reduces blood loss and transfusion requirements in hepatectomy.
- Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, and Wei-Feng Yu.
- Zhi Li, Yu-Ming Sun, Fei-Xiang Wu, Li-Qun Yang, Zhi-Jie Lu, Wei-Feng Yu, Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China.
- World J. Gastroenterol. 2014 Jan 7; 20 (1): 303-9.
AimTo evaluate the effect of low central venous pressure (LCVP) on blood loss and blood transfusion in patients undergoing hepatectomy.MethodsElectronic databases and bibliography lists were searched for potential articles. A meta-analysis of all randomized controlled trials (RCTs) investigating LCVP in hepatectomy was performed. The following three outcomes were analyzed: blood loss, blood transfusion and duration of operation.ResultsFive RCTs including 283 patients were assessed. Meta-analysis showed that blood loss in the LCVP group was significantly less than that in the control group (MD = -391.95, 95%CI: -559.35--224.56, P < 0.00001). In addition, blood transfusion in the LCVP group was also significantly less than that in the control group (MD = -246.87, 95%CI: -427.06--66.69, P = 0.007). The duration of operation in the LCVP group was significantly shorter than that in the control group (MD = -18.89, 95%CI: -35.18--2.59, P = 0.02). Most studies found no significant difference in renal and liver function between the two groups.ConclusionControlled LCVP is a simple and effective technique to reduce blood loss and blood transfusion during liver resection, and appears to have no detrimental effects on liver and renal function.
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