Preoperative volume assessment using bioelectrical impedance analysis for minimizing blood loss during hepatic resection
- Authors
- Suh, Suk-Won; Park, Hyun Jeong; Choi, Yoo Shin
- Issue Date
- Apr-2022
- Publisher
- Elsevier B.V.
- Citation
- HPB, v.24, no.4, pp 568 - 574
- Pages
- 7
- Journal Title
- HPB
- Volume
- 24
- Number
- 4
- Start Page
- 568
- End Page
- 574
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/51499
- DOI
- 10.1016/j.hpb.2021.09.009
- ISSN
- 1365-182X
1477-2574
- Abstract
- Background: Maintaining low central venous pressure (CVP) is an effective strategy to reduce blood loss during hepatic resection. As an alternative to measuring CVP, which requires the placement of a central venous catheter, bioelectrical impedance analysis (BIA) is a noninvasive method recently used for monitoring volume status in critically ill patients. Methods: We investigated 192 patients who underwent hepatic resection from January 2017 to December 2020. The ratio of extracellular water:total body water (ECW/TBW), as an index of volume status, was measured using InBody S10 (Biospace, Seoul, Korea). The correlation between the ECW/TBW and CVP was determined, and their influences on operative outcomes were analyzed. Results: ECW/TBW and CVP showed a significant correlation; an ECW/TBW <0.378 correlated with a CVP <5 mmHg (R2 = 0.839, P<0.001). Estimated blood loss (EBL) was significantly increased in patients with an ECW/TBW ≥0.378 compared to those with a ratio <0.378 (508 ± 321 vs. 324 ± 193, mL, P<0.001). Identified predictors for an EBL ≥500 mL were operative time (odds ratio [OR], 1.008; 95% confidence interval [CI], 1.001–1.015; P = 0.021) and an ECW/TBW <0.378 (OR, 0.263; 95% CI, 0.121–0.572; P = 0.001). Conclusions: BIA can be utilized for preoperative volume assessment to minimize blood loss during hepatic resection. © 2021 International Hepato-Pancreato-Biliary Association Inc.
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