Stroke volume variation does not correlate with central venous pressure during hepatectomy

Pablo Parra-Membrives; José M Lorente-Herce; Granada Jiménez-Riera; Darío Martínez-Baena

doi:10.1016/j.hpb.2023.01.013

Stroke volume variation does not correlate with central venous pressure during hepatectomy

HPB (Oxford). 2023 May;25(5):518-520. doi: 10.1016/j.hpb.2023.01.013. Epub 2023 Feb 9.

Authors

Pablo Parra-Membrives¹, José M Lorente-Herce², Granada Jiménez-Riera³, Darío Martínez-Baena³

Affiliations

¹ Associate Professor of the Department of Surgery, University of Seville, Spain; Hepatobiliary and Pancreatic Surgery Unit of the General and Digestive Surgery Department, Valme University Hospital, Sevilla, Spain. Electronic address: pabloparra@aecirujanos.es.
² Hepatobiliary and Pancreatic Surgery Unit of the General and Digestive Surgery Department, Valme University Hospital, Sevilla, Spain.
³ Associate Professor of the Department of Surgery, University of Seville, Spain; Hepatobiliary and Pancreatic Surgery Unit of the General and Digestive Surgery Department, Valme University Hospital, Sevilla, Spain.

PMID: 36822927
DOI: 10.1016/j.hpb.2023.01.013

Abstract

Background: Central venous pressure measurement has been the standard for patient monitoring during hepatectomy to assure low pressure and reduce blood loss. Recently SVV has been employed to monitor preload and guide fluid replacement during liver surgery. The aim of the study is to determine if SVV correlates with CVP values and may replace CVP measurement.

Methods: From January 2021 to February 2022 thirty patients undergoing 32 liver resections were included in the study. Repeated paired data of CVP and SVV were determined every 10 minutes throughout liver resection. The Correlation between CVP and SVV values was calculated. Analysis was then stratified by surgical approach, hilar clamping tempus, operative timing and PEEP values.

Results: A total number of 519 paired SSV/CVP values were recorded. Only a very weak correlation between SSV and CVP was detected (Pearson coefficient -0.122/ p=0.005). The results were unaltered after the stratified analysis by surgical approach, presence of hilar clamping, operative timing and PEEP use, revealing no correlation between SSV and CVP values.

Conclusion: The CVP /SVV values do not show a relevant correlation during liver surgery. CVP measurement is still of value and should not be replaced by SVV monitoring to conduct a safe hepatectomy.

MeSH terms

Central Venous Pressure
Hepatectomy* / adverse effects
Hepatectomy* / methods
Humans
Liver*
Monitoring, Physiologic / methods
Stroke Volume