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Intraoperative circulatory management using the F lo T rac TM system in laparoscopic liver resection
Author(s) -
Kitaguchi Kazuhiko,
Gotohda Naoto,
Yamamoto Hiroyuki,
Kato Yuichiro,
Takahashi Shinichiro,
Konishi Masaru,
Hayashi Ryuichi
Publication year - 2015
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12158
Subject(s) - medicine , perioperative , pneumoperitoneum , circulatory system , stroke volume , anesthesia , laparoscopy , central venous pressure , hemodynamics , cardiac output , resection , surgery , blood pressure , heart rate , cardiology
Several studies have shown that maintenance of the central venous pressure at a low level during liver surgery is effective for intraoperative management. However, others have suggested that stroke volume variation ( SVV ) may be a better predictor of fluid responsiveness than central venous pressure. The purpose of this study is to conduct a new type of circulatory management using the F lo T rac TM system in laparoscopic liver resection and to evaluate specific fluctuations in SVV . Methods Of the laparoscopic liver resections that we performed between M arch 2012 and D ecember 2013, we used the FloTrac system for intraoperative circulatory management in 21 cases. We analyzed the data, mainly the average value of SVV . Results The average SVV value during liver transection was 5.2%–24.6% (mean, 17.0%), and 18 cases (86%) exceeded the conventional cut‐off value (13%). The average SVV value was 4.3%–18.2% (mean, 9.7%) when pneumoperitoneum was not in effect, whereas it was 7.3% greater on average during liver transection (mean, 17.0%). No perioperative complications developed. Conclusion The average SVV value during laparoscopic liver transection (mean, 17.0%) exceeded the conventional cut‐off value, but in this study, no perioperative complications developed, which enabled safe management. We might be able to manage appropriate fluid control using FloTrac system in patients with laparoscopic liver resection. Therefore, it is necessary to set the target SVV and conduct prospective trials to verify the safety margin for intraoperative management in the future.