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Significance of stroke volume variation during hepatic resection under infrahepatic inferior vena cava and portal triad clamping

Norifumi Harimoto, Hiroyuki Matsuyama, Kiyoshi Kajiyama, Takashi Nagaie, Toru Ikegami, Tomoharu Yoshizumi, Yuji Soejima, Ken Shirabe, Tetsuo Ikeda, Hirofumi Kawanaka, Hideaki Uchiyama, Yo-Ichi Yamashita, Masaru Morita, Eiji Oki, Hiroshi Saeki, Yoshihiko Maehara
Fukuoka Igaku Zasshi, Hukuoka Acta Medica 2013, 104 (10): 362-9
24511667

PURPOSE: Stroke volume variation (SVV), which is measured by analyzing arterial blood pressure waveform characteristics, is a simple and sensitive indicator of fluid responsiveness. The current retrospective study was to investigate SVV and central venous pressure (CVP) during hepatic resection under clamping of both the infrahepatic inferior vena cava (IVC) and the portal triad.

METHODS: All hepatic resections performed from December 2009 to February 2010 at the Department of Surgery at Iizuka Hospital in Japan were included in this study. Invasive hemodynamic monitoring including CVP and SVV were performed in 14 patients.

RESULTS: CVP was significantly lower in patients with blood loss < or = 486 g than in those with blood loss > 486 g. SVV was significantly higher in patients with blood loss < or = 486 g than those with blood loss > 486 g during both IVC clamping and IVC + portal triad clamping. Estimated blood loss was significantly less in the group with SVV values > 18% compared to the group with values < or = 18%. There was a significant correlation between SVV and CVP (R2 = 0.714; P < .01).

CONCLUSION: SVV is a useful indicator of intraoperative blood loss without the monitoring of CVP during hepatic resection under clamping of both the infrahepatic IVC and the portal triad.

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