Controlled low central venous pressure reduces blood loss and transfusion requirements in hepatectomy

AIM:To evaluate the effect of low central venous pressure(LCVP)on blood loss and blood transfusion in patients undergoing hepatectomy.METHODS:Electronic databases and bibliography lists were searched for potential articles.A meta-analysis of all randomized controlled trials(RCTs)investigating LCVP in hepatectomy was performed.The following three outcomes were analyzed:blood loss,blood transfusion and duration of operation.RESULTS:Five RCTs including 283 patients were assessed.Meta-analysis showed that blood loss in the LCVP group was significantly less than that in the control group(MD=-391.95,95%CI:-559.35--224.56,P<0.00001).In addition,blood transfusion in the LCVP group was also significantly less than that in the control group(MD=-246.87,95%CI:-427.06--66.69,P=0.007).The duration of operation in the LCVP group was significantly shorter than that in the control group(MD=-18.89,95%CI:-35.18--2.59,P=0.02).Most studies found no significant difference in renal and liver function between the two groups.CONCLUSION:Controlled LCVP is a simple and effective technique to reduce blood loss and blood transfusion during liver resection,and appears to have no detrimental effects on liver and renal function.