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Goal-directed fluid therapy during post-resection phase in low central venous pressure assisted laparoscopic hepatectomy: a randomized controlled superiority trial

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Abstract

Purpose

The purpose of this prospective single blinded randomized controlled trial was to find out whether goal-directed fluid therapy (GDFT) strategy in post-transection period in low central venous pressure (CVP) assisted laparoscopic hepatectomy (LH) has more benefit than traditional fluid strategy.

Methods

Between April 2020 and Dec 2021, patients who were scheduled for laparoscopic liver resection surgery were eligible to participate in the study. Patients were randomly divided into two groups: control group that received traditional fluid strategy in post-transection period in low CVP assisted laparoscopic hepatectomy and GDFT strategy group that received GDFT strategy in post-transection period. The primary outcome parameter is the incidence of postoperative complications. Secondary outcome parameters include perioperative clinical outcomes, postoperative clinical outcomes, length of hospital stay after surgery, postoperative lactic acid, fluids and vasoactive medications during the operation.

Results

A total of 159 patients in the control group and 160 patients in the GDFT were included. Two groups had no significant difference in the incidence of postoperative complications including pneumonia (P = 0.34), acute kidney injury (P = 0.72), hepatic insufficiency (P = 0.25), pleural effusion (P = 0.08) and seroperitoneum (P = 1.00), respectively. The amount of perioperative urine output is fewer in GDFT group than in the control group (P = 0.0354), while other perioperative variables and postoperative variables were comparable between two groups.

Conclusions

The results show the implementation of GDFT strategy is not associated with fewer postoperative complications. GDFT strategy did not result in improved outcomes in low CVP-assisted laparoscopic hepatectomy.

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Data availability

The data that support the fndings of this study are available on request from the corresponding author, YH.

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Funding

This research was supported by the Shanghai Municipal Key Clinical Specialty (Grant number: shslczdzk03603) and Edward (Shanghai) Medical Supplies Co., Ltd (Grant number: 2017-ji-27) to Jing Cang.

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Author notes

  1. Shichao Li and Yue Yin are co-first authors.

Authors and Affiliations

  1. Department of Anesthesiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Shichao Li, Yue Yin, Pei Wang, Long Jiang, Huan Yan & Jing Cang

Authors
  1. Shichao Li
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  2. Yue Yin
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  3. Pei Wang
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  4. Long Jiang
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  5. Huan Yan
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  6. Jing Cang
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Contributions

Conception and design: JC, HY, SL; administrative support: JC; provision of study materials or patients: HY, SL, YY; collection and assembly of data: YY, PW, LJ; data analysis and interpretation: SL, HY; manuscript writing: all authors; final approval of manuscript: all authors.

Corresponding authors

Correspondence to Huan Yan or Jing Cang.

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Conflict of interest

Jing Cang received research support from Edward (Shanghai) Medical Supplies Co., Ltd. Shichao Li, Yue Yin, Pei Wang, Long Jiang and Huan Yan declare that they have no competing interests.

Ethical statement

This study has been approved by the Ethics Committee of Zhongshan Hospital Fudan University (Approval No.: B2018-303R). The study has been registered in Chinese Clinical Trial Registry (www.chictr.org.cn) and the registration number is ChiCTR1900027017. Written informed consent was obtained from all participants. The research is conducted in accordance with the Declaration of Helsinki (as revised in 2013).

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Li, S., Yin, Y., Wang, P. et al. Goal-directed fluid therapy during post-resection phase in low central venous pressure assisted laparoscopic hepatectomy: a randomized controlled superiority trial. J Anesth 38, 77–85 (2024). https://doi.org/10.1007/s00540-023-03282-5

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  • DOI: https://doi.org/10.1007/s00540-023-03282-5

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