Application of controlled low central venous pressure in precision liver resection

Objective To assess the effect of controlled low central venous pressure（CLCVP） on blood loss and renal function during precision liver resection. Methods Fifty patients were randomly divided into LCVP group（n=25）and control group（n=25）.The patients underwent LCVP under venous and inhalation anesthesia,during which their central venous pressure（CVP） and invasive blood pressure were continuously monitored.The CVP of patients in LCVP group was controlled below 4mmHg from the beginning of anesthesia to the resection of lesions and hemostasis by limiting the fluid infusion,raising the head to 10°-15°,inhaling isoflurane and/or continuously pumping nitroglycerin at 0.1-2μg/kg.min.The CVP of patients in control group was maintained at the normal range.Blood loss and blood transfusion were measured during operation.Creatinine（Cr） and blood urea nitrogen（BUN） in venous blood sample were detected before and 24h after operation. Results The blood loss was lower in LCVP group than in control group（（342.3±208.2）ml vs（648.4±381.2）ml,P＜0.05）.No significant difference was found in renal function between the two groups before and after operation（P＞0.05）. Conclusion Application of LCVP in precision liver resection can significantly reduce blood loss during operation with no remarkable effect on renal function.