کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3861694 1598888 2015 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The Impact of Pelvic Venous Pressure on Blood Loss during Open Radical Cystectomy and Urinary Diversion: Results of a Secondary Analysis of a Randomized Clinical Trial
ترجمه فارسی عنوان
تأثیر فشار داخل وریدی لگن در از دست رفتن خون در دوران سکته مغزی رادیال و انحراف ادراری: نتایج یک تحلیل ثانویه یک آزمایش بالینی تصادفی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
چکیده انگلیسی

PurposeBlood loss and blood substitution are associated with higher morbidity after major abdominal surgery. During major liver resection low local venous pressure decreases blood loss. Ambiguity persists concerning the impact of local venous pressure on blood loss during open radical cystectomy. We determined the association between intraoperative blood loss and pelvic venous pressure as well as factors affecting pelvic venous pressure.Materials and MethodsIn this single center, double-blind, randomized trial pelvic venous pressure was measured in 82 patients in a norepinephrine-low volume group and in 81 controls with liberal hydration. As secondary analysis patients from each arm were stratified into subgroups with pelvic venous pressure less than 5 mm Hg, or 5 or greater as measured after cystectomy, which is the optimal cutoff for identifying patients with relevant blood loss according to the Youden index.ResultsMedian blood loss was 800 ml (range 300 to 1,600) in 55 of 163 patients (34%) with pelvic venous pressure less than 5 mm Hg and 1,200 ml (range 400 to 3,000) in 108 of 163 (66%) with pelvic venous pressure 5 mm Hg or greater (p <0.0001). Pelvic venous pressure less than 5 mm Hg was measured in 42 of 82 patients (51%) in the norepinephrine-low volume group and in 13 of 81 controls (16%) (p <0.0001). Pelvic venous pressure decreased significantly after removing abdominal packing and abdominal lifting in each group at all time points, that is at the beginning and end of pelvic lymph node dissection, and the end of cystectomy (p <0.0001). No correlation was detected between pelvic venous pressure and central venous pressure.ConclusionsBlood loss was significantly decreased in patients with low pelvic venous pressure. Factors affecting pelvic venous pressure were fluid management and abdominal packing.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 194, Issue 1, July 2015, Pages 146–152
نویسندگان
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