A Comparison between Low Central Venous Pressure Technique and Conventional Technique to Minimize Blood Loss during Liver Resection: a Retrospective Study

Abstract

Background: The Low central venous pressure (LCVP) technique has been accepted as a method to minimize blood loss during liver resection. The LCVP technique intends to control the CVP levels at less than 5 mmHg. However, this technique may cause hemodynamic instability and renal complications. Objective: This retrospective study aimed to demonstrate the benefit of the LCVP technique in terms of blood loss, vasopressors requirement, an incidence of acute kidney injury compared to the conventional technique in liver resection surgery. Methods: After approval of IRB, the data of patients who underwent liver resection were divided into two groups; the LCVP and conventional groups. Demographic data, intraoperative vasopressors requirements, estimated blood loss (EBL), packed red blood cell (PRBC) transfusion and serum creatinine were reviewed retrospectively. Results: One hundred thirteen patients underwent liver resection; 57 patients received the LCVP technique while conventional technique applied to 56 patients. EBL in conventional technique group was 700 (500-1400) mL whereas in LCVP technique group was 400 (200-575) mL (P=0.001). Eleven (19.3%) patients in LCVP group required PRBC transfusion whereas 21 (37.5%) patients in conventional group (P=0.032). There was no significant difference in vasopressor requirement between groups. Lastly, the incidence of acute kidney injury (AKI) in the conventional group and the LCVP group were 3 (5.4%) and 3 (5.3%) respectively (P=0.982). Conclusion: This study demonstrated the benefit of the LCVP technique in reducing blood loss and PRBC transfusion. There was no increase in vasopressor requirements or incidence of AKI in the LCVP technique compared to the conventional technique in liver resection.