{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:34:21Z","timestamp":1753893261368,"version":"3.41.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The maintenance of low central venous pressure (CVP) during hepatic resection is associated with a reduction in estimated blood loss. After completion of the hepatic parenchymal transection, fluid is rapidly administered to replace the surgical blood loss and fluid deficit to prevent subsequent organ injury risk. However, this perioperative fluid strategy may influence on the postoperative outcomes of patients with left ventricular diastolic dysfunction (LVDD) who cannot tolerate volume adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A total of 206 patients with who underwent hepatic resection between March 2015 and February 2021 were evaluated. LVDD was defined according to the American Society of Echocardiography and the European Association of Cardiovascular Imaging 2016 recommendations as LVDD (group A, <jats:italic>n<\/jats:italic>\u2009=\u200939), or normal LV diastolic function and indeterminate decision (group B, <jats:italic>n<\/jats:italic>\u2009=\u2009153). We compared the clinical outcomes of patients between two groups, and then analyzed the risk factors for postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Postoperative acute kidney injury (AKI, 10.3% vs. 1.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.004) and pleural effusion or edema (51.3% vs. 30.1%, <jats:italic>P<\/jats:italic>\u2009=\u20090.013) were more common in group A than in group B. Further, creatinine levels from postoperative day 1 to day 7 were significantly higher and daily urine outputs at postoperative day 1 (<jats:italic>P<\/jats:italic>\u2009=\u20090.038) and day 2 (<jats:italic>P<\/jats:italic>\u2009=\u20090.025) were significantly lower in group A than in group B. LVDD was the only significant risk factor for postoperative AKI after hepatic resection (odds ratio, 10.181; 95% confidence interval, 1.570\u201366.011, <jats:italic>P<\/jats:italic>\u2009=\u20090.015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The rates of renal dysfunction and pulmonary complications after hepatic resection are higher in patients with LVDD than in those with normal LV diastolic function. Thus, these patients require individualized fluid management.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.1036850","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T05:26:53Z","timestamp":1668576413000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Influence of fluid balance on postoperative outcomes after hepatic resection in patients with left ventricular diastolic dysfunction"],"prefix":"10.3389","volume":"9","author":[{"given":"Jungho","family":"Shin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suk-Won","family":"Suh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/j.jamcollsurg.2014.12.026","article-title":"Hepatic parenchymal preservation surgery: decreasing morbidity and mortality rates in 4,152 resections for malignancy","volume":"220","author":"Kingham","year":"2015","journal-title":"J Am Coll Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"297971","DOI":"10.1155\/2013\/297971","article-title":"Efficacy and safety of hepatectomy performed with intermittent portal triad clamping with low central venous pressure","volume":"2013","author":"Topaloglu","year":"2013","journal-title":"Biomed Res Int"},{"key":"B3","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1111\/hpb.12462","article-title":"Central venous pressure and liver resection: a systematic review and meta-analysis","volume":"17","author":"Hughes","year":"2015","journal-title":"HPB (Oxford)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"290234","DOI":"10.1155\/2015\/290234","article-title":"Effectiveness and safety of controlled venous pressure in liver surgery: a systematic review and network meta-analysis","volume":"2015","author":"Zhang","year":"2015","journal-title":"Biomed Res Int"},{"key":"B5","doi-asserted-by":"publisher","first-page":"664","DOI":"10.12659\/AOT.905612","article-title":"Effect and outcome of intraoperative fluid restriction in living liver donor hepatectomy","volume":"22","author":"Wang","year":"2017","journal-title":"Ann Transplant"},{"key":"B6","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1111\/hpb.12347","article-title":"Renal function after low central venous pressure-assisted liver resection: assessment of 2116 cases","volume":"17","author":"Correa-Gallego","year":"2015","journal-title":"HPB (Oxford)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1016\/j.echo.2016.01.011","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American society of echocardiography and the European association of cardiovascular imaging","volume":"17","author":"Nagueh","year":"2016","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B8","doi-asserted-by":"publisher","first-page":"14096","DOI":"10.1038\/s41598-019-50582-6","article-title":"Risk factors of postoperative major adverse cardiac events after radical cystectomy: implication of diastolic dysfunction","volume":"9","author":"Jun","year":"2019","journal-title":"Sci Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.ejim.2019.11.019","article-title":"Impact of left ventricular dysfunction and fluid balance on the outcomes of patients with sepsis","volume":"74","author":"Hong","year":"2020","journal-title":"Eur J Intern Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1007\/s00134-015-3748-7","article-title":"Diastolic dysfunction and mortality in septic patients: a systematic review and meta-analysis","volume":"41","author":"Sanfilippo","year":"2015","journal-title":"Intensive Care Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"R74","DOI":"10.1186\/cc6916","article-title":"A positive fluid balance is associated with a worse outcome in patients with acute renal failure","volume":"12","author":"Payen","year":"2008","journal-title":"Crit Care"},{"key":"B12","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1007\/s00540-019-02728-z","article-title":"Preoperative elevated E\/e\u2019 (\u2265\/ 15) with preserved ejection fraction is associated with the development of postoperative heart failure in intermediate-risk non-cardiac surgical patients","volume":"34","author":"Higashi","year":"2020","journal-title":"J Anesth"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"Vandenbroucke JP; STROBE initiative. 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