Invasive central venous monitoring during hepatic resection: unnecessary for most patients.

Journal Article (Journal Article)

BACKGROUND: Low central venous pressure (LCVP) anesthesia reduces blood loss during hepatic resection and historically has required a central venous catheter (CVC) for intra-operative monitoring. The aim of this study was to assess the effect of an evolution of practice to CVP monitoring without CVC on the perioperative outcomes after liver resection. METHODS: A retrospective study of partial hepatectomy patients from 2007 to 2016 who were over 18 years of age was performed. RESULTS: Of 3903 patients having partial hepatectomy, 2445 (62%) met inclusion criteria, and 404 (16%) had a CVC. Overall morbidity (33% non-CVC vs 38% CVC P = 0.076), major morbidity (16% vs 20% P = 0.067), and infective complications (superficial wound infection) 3% vs 4% P = 0.429; deep wound infection (5% vs 6% P = 0.720) did not differ between the two groups. In multivariate analysis, superficial wound infection, deep wound infection, and major complications were not associated with the presence of a CVC. All-cause mortality at 90 days was associated with CVC presence (OR 3.45, CI 1.74-6.85, P = 0.001) and age (OR 1.05, CI 1.02-1.08, P < 0.001). CONCLUSION: Since the adoption of non-invasive CVP monitoring, there has been no increase in adverse peri-operative outcomes.

Full Text

Duke Authors

Cited Authors

  • O'Connor, DC; Seier, K; Gonen, M; McCormick, PJ; Correa-Gallego, C; Parker, B; Weiser, E; Balachandran, VP; Dematteo, RP; D'Angelica, M; Kingham, PT; Allen, PJ; Drebin, JA; Jarnagin, WR; Fischer, ME

Published Date

  • December 2020

Published In

Volume / Issue

  • 22 / 12

Start / End Page

  • 1732 - 1737

PubMed ID

  • 32336555

Pubmed Central ID

  • 32336555

Electronic International Standard Serial Number (EISSN)

  • 1477-2574

Digital Object Identifier (DOI)

  • 10.1016/j.hpb.2020.03.020

Language

  • eng

Conference Location

  • England