Low Central Venous Pressure with Milrinone During Living Donor Hepatectomy
Maintaining a low central venous pressure (CVP) has been frequently used in liver resections to reduce blood loss. However, decreased preload carries potential risks such as hemodynamic instability. We hypothesized that a low CVP with milrinone would provide a better surgical environment and hemodyn...
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| Veröffentlicht in: | American journal of transplantation 2010-04, Vol.10 (4), p.877-882 |
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| creator | Ryu, H.‐G. Nahm, F. S. Sohn, H.‐M. Jeong, E.‐J. Jung, C.‐W. |
| description | Maintaining a low central venous pressure (CVP) has been frequently used in liver resections to reduce blood loss. However, decreased preload carries potential risks such as hemodynamic instability. We hypothesized that a low CVP with milrinone would provide a better surgical environment and hemodynamic stability during living donor hepatectomy. Thirty‐eight healthy adult liver donors were randomized to receive either milrinone (milrinone group, n = 19) or normal saline (control group, n = 19) infusion during liver resection. The surgical field was assessed using a four‐point scale. Intraoperative vital signs, blood loss, the use of vasopressors and diuretics and postoperative laboratory data were compared between groups. The milrinone group showed a superior surgical field (p < 0.001) and less blood loss (142 ± 129 mL vs. 378 ± 167 mL, p < 0.001). Vital signs were well maintained in both groups but the milrinone group required smaller amounts of vasopressors and less‐frequent diuretics to maintain a low CVP. The milrinone group also showed a more rapid recovery pattern after surgery. Milrinone‐induced low CVP improves the surgical field with less blood loss during living donor hepatectomy and also has favorable effects on intraoperative hemodynamics and postoperative recovery.
Milrinone‐induced low CVP improves the surgical field during living donor hepatectomy. |
| doi_str_mv | 10.1111/j.1600-6143.2010.03051.x |
| format | Article |
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Milrinone‐induced low CVP improves the surgical field during living donor hepatectomy.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/j.1600-6143.2010.03051.x</identifier><identifier>PMID: 20420642</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Biological and medical sciences ; Blood ; Blood & organ donations ; Blood Pressure - drug effects ; Central venous pressure ; Diuretics ; Hemodynamics ; Hepatectomy ; Humans ; Liver ; Liver, biliary tract, pancreas, portal circulation, spleen ; living donor hepatectomy ; Living Donors ; Medical sciences ; milrinone ; Milrinone - pharmacology ; Milrinone - therapeutic use ; Organ donors ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; surgical field ; Vasodilator Agents - pharmacology ; Vasodilator Agents - therapeutic use</subject><ispartof>American journal of transplantation, 2010-04, Vol.10 (4), p.877-882</ispartof><rights>©</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Wiley Subscription Services, Inc. Apr 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5081-9cc42443ebae58496d468488055f9e00b6f0f975d67f88b13c700361c43b92bd3</citedby><cites>FETCH-LOGICAL-c5081-9cc42443ebae58496d468488055f9e00b6f0f975d67f88b13c700361c43b92bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-6143.2010.03051.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-6143.2010.03051.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22751803$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20420642$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ryu, H.‐G.</creatorcontrib><creatorcontrib>Nahm, F. S.</creatorcontrib><creatorcontrib>Sohn, H.‐M.</creatorcontrib><creatorcontrib>Jeong, E.‐J.</creatorcontrib><creatorcontrib>Jung, C.‐W.</creatorcontrib><title>Low Central Venous Pressure with Milrinone During Living Donor Hepatectomy</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Maintaining a low central venous pressure (CVP) has been frequently used in liver resections to reduce blood loss. However, decreased preload carries potential risks such as hemodynamic instability. We hypothesized that a low CVP with milrinone would provide a better surgical environment and hemodynamic stability during living donor hepatectomy. Thirty‐eight healthy adult liver donors were randomized to receive either milrinone (milrinone group, n = 19) or normal saline (control group, n = 19) infusion during liver resection. The surgical field was assessed using a four‐point scale. Intraoperative vital signs, blood loss, the use of vasopressors and diuretics and postoperative laboratory data were compared between groups. The milrinone group showed a superior surgical field (p < 0.001) and less blood loss (142 ± 129 mL vs. 378 ± 167 mL, p < 0.001). Vital signs were well maintained in both groups but the milrinone group required smaller amounts of vasopressors and less‐frequent diuretics to maintain a low CVP. The milrinone group also showed a more rapid recovery pattern after surgery. Milrinone‐induced low CVP improves the surgical field with less blood loss during living donor hepatectomy and also has favorable effects on intraoperative hemodynamics and postoperative recovery.
Milrinone‐induced low CVP improves the surgical field during living donor hepatectomy.</description><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Blood & organ donations</subject><subject>Blood Pressure - drug effects</subject><subject>Central venous pressure</subject><subject>Diuretics</subject><subject>Hemodynamics</subject><subject>Hepatectomy</subject><subject>Humans</subject><subject>Liver</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>living donor hepatectomy</subject><subject>Living Donors</subject><subject>Medical sciences</subject><subject>milrinone</subject><subject>Milrinone - pharmacology</subject><subject>Milrinone - therapeutic use</subject><subject>Organ donors</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>surgical field</subject><subject>Vasodilator Agents - pharmacology</subject><subject>Vasodilator Agents - therapeutic use</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1vEzEQhq0K1JbSv4AsIdRTwvjbe-BQpUCpguBQerW8zixstFmn9m7T_Ht2mxAkLsWXGdnPzLyelxDKYMqG8345ZRpgopkUUw7DLQhQbPp4RE4PDy8OuVAn5FXOSwBmuOXH5ISD5KAlPyU387ihM2y75Bt6h23sM_2eMOc-Id3U3S_6tW5S3cYW6VU_JD_pvH4Yw1VsY6LXuPYdhi6utq_Jy8o3Gc_38Yz8-PTxdnY9mX_7_GV2OZ8EBZZNihAkl1Jg6VFZWeiF1FZaC0pVBQKUuoKqMGqhTWVtyUQwAEKzIEVZ8HIhzsjFru86xfsec-dWdQ7YNL7FQb4zUoMRYM3zpBAFEwUXA_n2H3IZ-9QO33BcMW1NoZ_62R0VUsw5YeXWqV75tHUM3GiMW7px527cvxuNcU_GuMeh9M1-QF-ucHEo_OPEALzbAz4H31TJt6HOfzluFLMwKv2w4zZ1g9v_FuAub27HTPwG0Nul-A</recordid><startdate>201004</startdate><enddate>201004</enddate><creator>Ryu, H.‐G.</creator><creator>Nahm, F. S.</creator><creator>Sohn, H.‐M.</creator><creator>Jeong, E.‐J.</creator><creator>Jung, C.‐W.</creator><general>Blackwell Publishing Inc</general><general>Wiley</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201004</creationdate><title>Low Central Venous Pressure with Milrinone During Living Donor Hepatectomy</title><author>Ryu, H.‐G. ; Nahm, F. S. ; Sohn, H.‐M. ; Jeong, E.‐J. ; Jung, C.‐W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5081-9cc42443ebae58496d468488055f9e00b6f0f975d67f88b13c700361c43b92bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Blood & organ donations</topic><topic>Blood Pressure - drug effects</topic><topic>Central venous pressure</topic><topic>Diuretics</topic><topic>Hemodynamics</topic><topic>Hepatectomy</topic><topic>Humans</topic><topic>Liver</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>living donor hepatectomy</topic><topic>Living Donors</topic><topic>Medical sciences</topic><topic>milrinone</topic><topic>Milrinone - pharmacology</topic><topic>Milrinone - therapeutic use</topic><topic>Organ donors</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>surgical field</topic><topic>Vasodilator Agents - pharmacology</topic><topic>Vasodilator Agents - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ryu, H.‐G.</creatorcontrib><creatorcontrib>Nahm, F. 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S.</au><au>Sohn, H.‐M.</au><au>Jeong, E.‐J.</au><au>Jung, C.‐W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low Central Venous Pressure with Milrinone During Living Donor Hepatectomy</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2010-04</date><risdate>2010</risdate><volume>10</volume><issue>4</issue><spage>877</spage><epage>882</epage><pages>877-882</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Maintaining a low central venous pressure (CVP) has been frequently used in liver resections to reduce blood loss. However, decreased preload carries potential risks such as hemodynamic instability. We hypothesized that a low CVP with milrinone would provide a better surgical environment and hemodynamic stability during living donor hepatectomy. Thirty‐eight healthy adult liver donors were randomized to receive either milrinone (milrinone group, n = 19) or normal saline (control group, n = 19) infusion during liver resection. The surgical field was assessed using a four‐point scale. Intraoperative vital signs, blood loss, the use of vasopressors and diuretics and postoperative laboratory data were compared between groups. The milrinone group showed a superior surgical field (p < 0.001) and less blood loss (142 ± 129 mL vs. 378 ± 167 mL, p < 0.001). Vital signs were well maintained in both groups but the milrinone group required smaller amounts of vasopressors and less‐frequent diuretics to maintain a low CVP. The milrinone group also showed a more rapid recovery pattern after surgery. Milrinone‐induced low CVP improves the surgical field with less blood loss during living donor hepatectomy and also has favorable effects on intraoperative hemodynamics and postoperative recovery.
Milrinone‐induced low CVP improves the surgical field during living donor hepatectomy.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>20420642</pmid><doi>10.1111/j.1600-6143.2010.03051.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biological and medical sciences Blood Blood & organ donations Blood Pressure - drug effects Central venous pressure Diuretics Hemodynamics Hepatectomy Humans Liver Liver, biliary tract, pancreas, portal circulation, spleen living donor hepatectomy Living Donors Medical sciences milrinone Milrinone - pharmacology Milrinone - therapeutic use Organ donors Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system surgical field Vasodilator Agents - pharmacology Vasodilator Agents - therapeutic use |
| title | Low Central Venous Pressure with Milrinone During Living Donor Hepatectomy |
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