Document Detail


Low central venous pressure with milrinone during living donor hepatectomy.
MedLine Citation:
PMID:  20420642     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H-G Ryu; F S Nahm; H-M Sohn; E-J Jeong; C-W Jung
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  10     ISSN:  1600-6143     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-27     Completed Date:  2010-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  877-82     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure / drug effects*
Hepatectomy*
Humans
Living Donors*
Milrinone / pharmacology,  therapeutic use*
Vasodilator Agents / pharmacology,  therapeutic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 78415-72-2/Milrinone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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