Effect of stroke volume variation-directed fluid management on blood loss during living-donor right hepatectomy: a randomised controlled study.
Choi SS, Jun IG, et al.Anaesthesia 2015 [record in progress].
Aims
To compare the effect on blood loss of variating stroke volumes during living donor right hepatectomy.
Interventions
Patients were randomized to either a high stroke volume variation (SVV) group (10-20% SVV), or control group (<10% SVV).
Participants
80 patients scheduled for elective living-donor right lobectomy aged ≥ 20 years
Outcomes
The primary outcome measured was intra-operative blood loss. Secondary measured outcomes were intra-operative heamodynamic variables, peri-operative laboratory data and postoperative complications.
Follow-up
End of hospital stay
CET Conclusions
This well-designed trial from Seoul investigates the effects of anaesthetic management on blood loss during right lobe live-donor hepatectomy. Patients were randomised to maintain a high stroke volume variation (SVV) or a control group during the procedure, on the basis of previous work from the group which suggested that a high SVV may be beneficial. There was a significantly lower blood loss in the high SVV group (476 vs 836 ml), with all other outcomes equal. The study was well designed, with blinding of outcome assessment and surgeons to the allocated groups. As the authors point out, there was also a significantly lower central venous pressure in the treatment group which could also account for a reduction in blood loss, and they were unable to disentangle the relative contributions of the two parameters to the reduction in blood loss seen.
Data analysis
Modified intention-to-treat analysis
Trial registration
Clinical Research Information Service - KCT0000845