Comparison of Stroke Volume Variation Versus Central Venous Pressure Guidance to Reduce Blood Loss During Open Liver Resection: A Randomized Controlled Study

What this Trial Is About

Liver resection surgery can involve significant blood loss, which increases the risk of complications and death. This trial compares two methods used during open liver resection to reduce blood loss: maintaining a high stroke volume variation (SVV) and keeping a low central venous pressure (CVP). The study aims to determine which method better minimizes perioperative blood loss and improves patient outcomes. Participants will be randomly assigned to one of two groups. In the high SVV group, anesthesiologists will maintain SVV between 13-20% during the liver transection phase using the FloTrac-Vigileo system for fluid management, while CVP monitoring is hidden. In the low CVP group, the anesthesiologists will keep CVP below 5 mmHg during liver transection and use CVP to guide fluids, concealing SVV monitoring. Both methods involve fluid restriction during transection and fluid resuscitation afterward. Throughout the study, researchers will measure blood loss during liver transection and the entire surgery, blood transfusions, surgical bleeding scores, and postoperative complications including kidney injury and liver failure. They will also monitor serum lactate levels, reoperation rates, intensive care and hospital stay lengths, mortality, and 30-day readmission. The study lasts from enrollment through 30 days after surgery, ensuring thorough safety and outcome monitoring.

Stroke Volume Variation Versus Central Venous Pressure Guidance for Reducing Perioperative Blood Loss During Open Liver Resection