Stroke Volume Variation Versus Central Venous Pressure Guidance for Reducing Perioperative Blood Loss During Open Liver Resection

Launched by WARANGKANA LAPISATEPUN · Mar 25, 2025

Keywords

ClinConnect Summary

This clinical trial is studying two different methods to manage blood loss during a major surgery called open liver resection, which is often needed for patients with liver tumors. The trial aims to compare the effectiveness of using stroke volume variation (a less invasive method that monitors blood flow) against the traditional method of measuring central venous pressure (a more invasive approach) to see which one better reduces blood loss during the surgery. Excessive bleeding during this procedure can lead to serious complications, so finding the best way to manage blood flow is really important.

To participate in this trial, patients must be between 18 and 70 years old, have certain types of liver tumors, and be in good health overall (classified as ASA I-III). However, those with certain medical conditions, such as pregnancy, significant heart issues, or kidney problems, will not be eligible. Participants can expect to be closely monitored during the surgery and will help contribute to important research that could improve outcomes for future liver surgery patients.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • All genders, age 18 to 70 years old
• • American Society of Anesthesiologists (ASA) physical status classification of I-III
• • The patients who scheduled in elective open liver resection and diagnosed Hepatocellular Carcinoma, Cholangiocarcinoma, Liver metastasis, and Benign malignant tumor.
• Exclusion Criteria:
• • Pregnancy
• • Active cardiac conditions (unstable coronary syndromes, decompensated heart failure, significant arrhythmias, severe valvular disease, active coronary artery disease within 6 months prior surgery)
• • History of significant cerebrovascular disease (Patients with clinically significant stroke/CVA within 6 months prior surgery, severe carotid stenosis)
• • Renal dysfunction (GFR \< 60 ml/min/1.73 m²)
• • Abnormal coagulation parameters (INR \>1.5 not on warfarin and/or platelet count \<100,000)
• • Preoperative autologous blood donation
• • Tumor size \> 10 cm.
• • Previous liver resection
• Withdrawal criteria:
• • Unresectable tumor
• • Persistent intraoperative hypotension that cannot be corrected with vasopressors.
• • Cardiac arrest during operation
• • Low central venous pressure (CVP \< 5 mmHg) or high stroke volume variation (SVV \>13%) cannot be achieved before and during liver parenchymal transection.