scholarly journals The efficacy and safety of controlled low central venous pressure for liver resection: a systematic review and meta-analysis

Gland Surgery ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 311-320
Author(s):  
Feiran Wang ◽  
Dongwei Sun ◽  
Nannan Zhang ◽  
Zhong Chen
Keyword(s):  
Systematic Review ◽  
Liver Resection ◽  
Central Venous Pressure ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Efficacy And Safety ◽  
Central Venous ◽  
Low Central Venous Pressure

scholarly journals P-L03 The efficacy and safety of controlled low central venous pressure for liver resection: a systematic review and meta-analysis

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Zhong Chen ◽  
Dundong Sun ◽  
Feiran Wang
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Central Venous Pressure ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Control Group ◽  
Significant Heterogeneity ◽  
Complication Rates ◽  
Central Venous ◽  
Low Central Venous Pressure

Abstract Background Partial hepatectomy is an effective treatment for benign and malignant liver diseases . However, intraoperative bleeding is one of the major factors affecting the outcome of hepatectomy. Currently, the most commonly used method of hepatic blood flow occlusion in clinical practice is Pringle method, but this method has a great impact on liver function and can cause hepatic ischemia-reperfusion injury. .Studies have shown that blood loss volume during hepatectomy is related to central venous pressure (CVP) . Intraoperative control of central venous pressure (LCVP) is increasingly popular in hepatectomy, but its effectiveness and safety remain controversial.  Methods The main result of the analysis was to reduce the blood loss and blood infusion. Secondary outcomes included operative time, fluid infusion, urine volume, ALT, TBIL, BUN, CR, postoperative complication rates and length of hospital stay. Statistical analysis was performed using RevMan 5.3 software (Cochrane Collaboration, Oxford, England). The results of all studies were measured by mean ± standard deviation. If there is significant heterogeneity between the results (P < 0.05), a random-effects model is used. A fixed-effect model was used when there was no significant heterogeneity (P > 0.05). Heterogeneity was assessed using the Cochrane χ2 text .  Results In total, 10 studies, involving 324 patients undergoing liver resection with controlled low central venous pressure, were identified. Meta-analysis showed that blood loss in the LCVP group was significantly less than that in the control group ( P = 0.0002). blood transfusion in the LCVP group was also significantly less than that in the control group(P = 0.0006). there was no difference between LCVP group and control group in operation time(P = 0.17), fluid infusion( P = 0.46), urinary volume(P = 0.38), ALT( P = 0.23), TBIL(P = 0.86), BUN(P = 0.67), CR(P =0.59), postoperative complication rates( P = 0.01) and hospital stay(P = 0.26).  Conclusions Compared with the control, controlled low central venous pressure showed comparable efficacy and safety for the treatment during liver resection.

scholarly journals Central venous pressure and liver resection: a systematic review and meta analysis

HPB ◽  
2015 ◽  
Vol 17 (10) ◽  
pp. 863-871 ◽  
Author(s):  
Michael J. Hughes ◽  
Nicholas T. Ventham ◽  
Ewen M. Harrison ◽  
Stephen J. Wigmore
Keyword(s):  
Systematic Review ◽  
Liver Resection ◽  
Central Venous Pressure ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Central Venous

scholarly journals Efficacy and Safety of Hepatectomy Performed with Intermittent Portal Triad Clamping with Low Central Venous Pressure

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Serdar Topaloglu ◽  
Kıymet Yesilcicek Calik ◽  
Adnan Calik ◽  
Coskun Aydın ◽  
Sema Kocyigit ◽  
...  
Keyword(s):  
Central Venous Pressure ◽  
Malignant Disease ◽  
Venous Pressure ◽  
Operation Time ◽  
Morbidity Rate ◽  
Efficacy And Safety ◽  
Central Venous ◽  
Portal Triad ◽  
Portal Triad Clamping ◽  
Low Central Venous Pressure

Background. This retrospective study was designed to investigate the efficacy and safety of intermittent portal triad clamping (PTC) with low central venous pressure (CVP) in liver resections.Methods. Between January 2007 and August 2013, 115 patients underwent liver resection with intermittent PTC. The patients’ data were retrospectively analyzed.Results. There were 58 males and 57 females with a mean age of 55 years (±13.7). Cirrhosis was found in 23 patients. Resections were performed for malignant disease in 62.6% (n=72) and for benign disease in 37.4% (n=43). Major hepatectomy was performed in 26 patients (22.4%). Mean liver ischemia period was 27.1 min (±13.9). The mortality rate was 1.7% and the morbidity rate was 22.6%. Cumulative clamping time (t=3.61,P<0.001) and operation time (t=2.38,P<0.019) were significantly correlated with AST alterations (D-AST). Cumulative clamping time (t=5.16,P<0.001) was significantly correlated with D-ALT. Operation time (t=5.81,P<0.001) was significantly correlated with D-LDH.Conclusions. Intermittent PTC under low CVP was performed with low morbidity and mortality. Intermittent PTC can be safely applied up to 60 minutes in both normal and impaired livers.

scholarly journals Renal function after low central venous pressure‐assisted liver resection: assessment of 2116 cases

HPB ◽  
2015 ◽  
Vol 17 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Camilo Correa‐Gallego ◽  
Alexandra Berman ◽  
Stephanie C. Denis ◽  
Liana Langdon‐Embry ◽  
David O'Connor ◽  
...  
Keyword(s):  
Renal Function ◽  
Liver Resection ◽  
Central Venous Pressure ◽  
Venous Pressure ◽  
Central Venous ◽  
Low Central Venous Pressure

Central venous pressure monitoring via peripherally or centrally inserted central catheters: a systematic review and meta-analysis

2017 ◽  
Vol 18 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Filippo Sanfilippo ◽  
Alberto Noto ◽  
Gennaro Martucci ◽  
Marco Farbo ◽  
Gaetano Burgio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Central Venous Pressure ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Central Venous ◽  
Clinical Criteria ◽  
Number Of Patients ◽  
The Difference ◽  
Meta Analyses ◽  
Central Catheters

Introduction The central venous pressure (CVP) is the most commonly used static marker of preload for guiding fluid therapy in critically ill patients, though its usefulness remains controversial. Centrally inserted central catheters (CICCs) are the gold-standard devices for CVP monitoring but peripherally inserted central catheters (PICCs) may represent a valid alternative. We undertook a systematic review and meta-analysis with the aim to investigate whether the difference between PICC- and CICC-measured CVP is not significant. Methods We searched for clinical studies published in PubMed and EMBASE databases from inception until December 21st 2016. We included studies providing data on paired and simultaneous CVP measurement from PICCs and CICCs. We conducted two analyses on the values of CVP, the first one according to the total number of CVP assessments, the second one considering the number of patients recruited. Results Four studies matched the inclusion criteria, but only three of them provided data for the meta-analyses. Both analyses showed non-significant differences between PICC-measured and CICC-measured CVP: 1489 paired simultaneous CVP assessments (MD 0.16, 95%CI −0.14, 0.45, p = 0.30) on a total of 57 patients (MD 0.22, 95%CI −1.46, 1.91, p = 0.80). Both analyses showed no heterogeneity (I2 = 0%). Conclusions Available evidence supports that CVP monitoring with PICCs is accurate and reproduces similar values to those obtained from CICCs. The possibility to monitor CVP should not be used among clinical criteria for preferring a CICC over a PICC line.

scholarly journals Ultrasound assessment of central venous pressure: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Jean Deschamps ◽  
Jed Lipes ◽  
Andrew Weinstock ◽  
Dev Jayaraman ◽  
Lawrence Rudski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Central Venous Pressure ◽  
Point Of Care ◽  
Meta Analysis ◽  
Venous Pressure ◽  
Vena Cava ◽  
Correlation Coefficients ◽  
Central Venous ◽  
Care Systems ◽  
Ventilated Patients

Abstract Background Ultrasound is increasingly relied upon to estimate central venous pressure (CVP) in the echocardiography lab and using point-of-care systems in the intensive care unit and the emergency department. However, there is uncertainty regarding the diagnostic accuracy of ultrasound-based parameters as reported in diverse studies.Methods A systematic review was performed by searching MEDLINE, EMBASE, and the Cochrane Database for studies evaluating ultrasound-based indicators of filling pressures in relation to catheterization-based CVP. Studies were screened for predefined inclusion criteria and rated for quality by duplicate observers. Standardized correlation coefficients for each ultrasound-based indicator were meta-analyzed using a random effects model.Results 3949 articles were screened and 64 met the criteria for inclusion. Inferior vena cava (IVC) diameter was assessed in 34 study measures and the pooled standardized correlation with invasive CVP was 0.74 (95% CI 0.63 to 0.84). IVC collapsibility was assessed in 20 study measures and the pooled standardized correlation with invasive CVP was -0.57 (95% CI -0.70 to -0.44). Tricuspid E/Ep was assessed in 6 study measures and the pooled standardized correlation with invasive CVP was 0.59 (95% CI 0.26 to 0.93). IVC parameters but not E/Ep remained correlated with CVP in mechanically ventilated patients, including cardiac surgery patients. Results were similar in studies featuring non-traditional users and cardiac specialists.Conclusions Echocardiographic IVC diameter, collapsibility, and tricuspid E/Ep ratio are significantly correlated with invasive CVP, albeit with important heterogeneity between studies. Most of these indicators are equally valid when applied in ventilated patients and by non-traditional users.

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