Observation of Achieving Controlled Low Central Venous Pressure with Goal-directed Fluid Therapy Combined with Milrinone in Laparoscopic Hepatic Lobectomy

Bo PENG; Gang SU; Rong QIN; Rong WEN; Wei YIN

doi:10.12259/j.issn.2095-610X.S20240918

Volume 45 Issue 9

Sep. 2024

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Article Navigation > Journal of Kunming Medical University > 2024 > 45(9): 116-121

Bo PENG, Gang SU, Rong QIN, Rong WEN, Wei YIN. Observation of Achieving Controlled Low Central Venous Pressure with Goal-directed Fluid Therapy Combined with Milrinone in Laparoscopic Hepatic Lobectomy[J]. Journal of Kunming Medical University, 2024, 45(9): 116-121. doi: 10.12259/j.issn.2095-610X.S20240918

Citation:

Bo PENG, Gang SU, Rong QIN, Rong WEN, Wei YIN. Observation of Achieving Controlled Low Central Venous Pressure with Goal-directed Fluid Therapy Combined with Milrinone in Laparoscopic Hepatic Lobectomy[J]. Journal of Kunming Medical University, 2024, 45(9): 116-121. doi: 10.12259/j.issn.2095-610X.S20240918

Citation:

Bo PENG, Gang SU, Rong QIN, Rong WEN, Wei YIN. Observation of Achieving Controlled Low Central Venous Pressure with Goal-directed Fluid Therapy Combined with Milrinone in Laparoscopic Hepatic Lobectomy[J]. Journal of Kunming Medical University, 2024, 45(9): 116-121. doi: 10.12259/j.issn.2095-610X.S20240918

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Observation of Achieving Controlled Low Central Venous Pressure with Goal-directed Fluid Therapy Combined with Milrinone in Laparoscopic Hepatic Lobectomy

doi: 10.12259/j.issn.2095-610X.S20240918

Dept. of Anesthesiology，First People’s Hospital of Kunming，Kunming Yunnan 650034，China

Received Date: 2024-03-26
Available Online: 2024-09-03
Publish Date: 2024-09-25

Abstract

Abstract

Objective To investigate the effect of goal-directed fluid therapy combined with milrinone in achieving controlled low central venous pressure （CLCVP） in laparoscopic hepatic lobectomy. Methods Sixty patients undergoing laparoscopic hepatectomy at the First People’ s Hospital of Kunming City from August 2021 to November 2023 were selected as the study subjects. They were randomLy divided into two groups, with 30 cases in each group: the control group and the experimental group. The control group received strict fluid therapy （infusion of crystalloid at a ratio of 1∶1 at 3 mL/kg） and Nitroglycerin infusion to achieve CLCVP based on the patient’ s condition. The experimental group received fluid therapy targeting SVV 1%～9% （infusion of crystalloid at a ratio of 1∶1 at 20 mL/kg） and milrinone was used in combination to achieve CLCVP. Surgical field satisfaction, blood loss, blood pressure changes, urine output, central venous pressure, and length of hospital stay were recorded for both groups. Results The intraoperative surgical field satisfaction of the experimental group was higher than that of the control group, with statistically significant differences （P < 0.05）; the total intraoperative blood loss and average blood loss in the experimental group were lower than those in the control group, and the surgical time was shorter than that of the control group, with statistically significant differences （P < 0.05）. There was no statistically significant difference in preoperative mean arterial pressure between the two groups （P > 0.05）. The experimental group had higher mean arterial pressure both intraoperatively and postoperatively than the control group, with statistically significant differences （P < 0.05）. There was no statistically significant difference in urine output between the two groups intraoperatively （P > 0.05）, but postoperatively, the urine output in the experimental group was higher than that in the control group. The average CVP value was lower in the experimental group than in the control group, with statistically significant differences （P < 0.05）. The total length of hospital stay and average length of hospital stay were shorter in the experimental group than in the control group, with statistically significant differences （P < 0.05）. Conclusion In laparoscopic liver resection surgery, the use of goal-directed fluid therapy combined with milrinone to achieve controlled low central venous pressure （CLCVP） significantly reduces intraoperative bleeding, maintains hemodynamic stability, shortens surgical and hospital stay, and improves surgeon’ s satisfaction with surgical field compared to the traditional strict fluid control method.
- Endoscopic hepatic lobectomy,
- Goal-directed fluid therapy,
- Milrinone,
- Controlled low central venous pressure technique

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References(17)

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