Invasive central venous monitoring during hepatic resection: Unnecessary for most patients Journal Article
| Authors: | O'Connor, D. C.; Seier, K.; Gonen, M.; McCormick, P. J.; Correa-Gallego, C.; Parker, B.; Weiser, E.; Balachandran, V. P.; Dematteo, R. P.; D'Angelica, M.; Kingham, P. T.; Allen, P. J.; Drebin, J. A.; Jarnagin, W. R.; Fischer, M. E. |
| Article Title: | Invasive central venous monitoring during hepatic resection: Unnecessary for most patients |
| Abstract: | 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. © 2020 International Hepato-Pancreato-Biliary Association Inc. |
| Journal Title: | HPB |
| Volume: | 22 |
| Issue: | 12 |
| ISSN: | 1365-182X |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2020-12-01 |
| Start Page: | 1732 |
| End Page: | 1737 |
| Language: | English |
| DOI: | 10.1016/j.hpb.2020.03.020 |
| PUBMED: | 32336555 |
| PROVIDER: | scopus |
| PMCID: | PMC7581625 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 January 2021 -- Source: Scopus |
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