Effect of low central venous pressure on postoperative pulmonary complications in patients undergoing liver transplantation.
Wang B, He H.K, et al.Surgery Today. 2013; 43(7): 777-781
Aims
To investigate the effect of low central venous pressure (LCVP) on postoperative pulmonary complications in patients undergoing orthotopic liver transplantation (OLT).
Interventions
LCVP blood pressure maintained below 5 mmHg, limited infusion volume, administration of nitroglycerine and posture manipulation. The control group did not receive nitroglycerine or posture manipulation, CVP in this group was maintained at 8 to 10 mmHg.
Participants
65 adults undergoing OLT.
Outcomes
Volume of intraoperative blood loss and transfusion, postoperative pulmonary complications including, pulmonary atelectasis, plural effusion, pneumonia, acute respiratory failure and pulmonary edema within 30 postoperative days.
Follow-up
1 year.
CET Conclusions
In this small randomised controlled trial ( of poor methodological quality) in liver transplant recipients, the 33 patients maintained with a low central venous pressure (below 5mmHg) had less pulmonary complications after surgery than those treated in the same way but with the central venous pressure maintained above 5mmHg. The authors suggest that this approach might reduce the pulmonary complications after liver transplantation. (The donors were all deceased donors with a median age of around 35 and no information was given as to whether the donors were executed prisoners or not).
Data analysis
Per protocol analysis
Trial registration
Not reported.