Clinical and Experimental Circulation
Hepatic resection surgery under low CVP anaesthesia - can FTc be used as an indicator of cardiac preload?
Background and Goal of Study: Hepatic resection surgery is commonly performed under low central venous pressure (CVP) anaesthesia (1). Given the significant haemodynamic changes encountered we have looked at the use of corrected flow time (FTc) as an indicator of cardiac preload using Trans Esophageal Doppler (CardioQ®).
Materials and Methods: We studied 10 consecutive patients undergoing elective hepatic resection surgery for isolated colorectal metastases under low CVP anaesthesia. All patients received a standardized general anaesthetic technique, combined with intraoperative reduction of CVP. Trans-Esophageal Doppler was used intraoperatively to obtain FTc. The same surgeon operated on all patients and an ultrasonic dissection method was utilized for the resection.
Results and Discussion: Data presented as mean values (95% CI as error bars). Mean fall in CVP was 5 cmH2O. Blood loss in all patients was in the range 100-600 mls.
Conclusion: In our study, trends in corrected flow time (FTc) obtained using Trans-Esophageal Doppler accurately reflected parallel changes in CVP. FTc may therefore be used as a guide to ensure adequate volume resuscitation following completion of the resection phase of surgery.
© 2007 European Society of Anaesthesiology
1 Eid A et al. Low CVP anesthesia in major hepatic resection. Middle East J Anesthesiol. 2005; 18(2): 367-77