Usefulness of Monitoring Stroke Volume Variations for Fluid Management During Pediatric Living-Donor Liver Transplantation

Yoshihiro Kasagi, Manabu Hashimoto, Shugo Kasuya, Seisuke Sakamoto, Mureo Kasahara, Yasuyuki Suzuki, Eiichi Inada

Department of Anesthesia and Intensive Care, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan.
Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan.
Transplantation Surgery, National Center for Child Health and Development, Okura, Setagaya-ku, Tokyo, Japan.

DOI: 10.4236/ojanes.2012.24033                

Abstract

Purpose: Central venous pressure (CVP) is considered to be unsuitable as preload parameter. Stroke volume variation (SVV) has recently been reported to be effective as a preload and fluid responsiveness parameter, and its usefulness for fluid management during living-donor liver transplantation (LDLT). However, use of SVV has not been reported in children. Our aim is to evaluate the use of SVV as a target parameter of circulating blood volume during pediatric LDLT. Methods: This retrospective study was conducted in 40 consecutive patients aged between 5 and 109 months who underwent elective LDLT. Twenty patients underwent LDLT without FloTrac? (C group) and the rest patients underwent LDLT with the FloTrac? monitoring (F group). As a fluid management target, CVP was maintained at 10 mmHg in the C group and SVV at 10% in the F group. We compared MAP and CVP at the times of the greatest decrease within 5 minutes after reperfusion. Results: MAP after reperfusion was significantly decreased in both groups (P < 0.01), with the magnitude of decrease significantly greater in the C group compared with the F group (P = 0.02). MAP before and after reperfusion did not significantly differ between the groups. After reperfusion, CVP was nearly the same in both groups, with that in the C group slightly decreased and nearly no change in the F group. SVV after reperfusion was significantly increased (P < 0.001). Conclusion: When used as a target parameter for fluid management during pediatric LDLT, hemodynamic changes was less when SVV was used as the parameter of circulating blood volume.

Keywords

Pediatric; Living-Donor Liver Transplantation; Fluid Management; Stroke Volume Variation; Reperfusion

Conflicts of Interest

The authors declare no conflicts of interest.

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