The feasibility of non-invasive cardiac output monitoring in living donor right hepatectomy – A prospective study.

Living donor liver transplantation (LDLT) is an established treatment modality for end-stage liver disease and it alleviates the shortage of cadaveric donor organs. Donor safety during the perioperative period is a major concern of LDLT. In general, hepatectomy causes a significant blood loss which is among the major causes of post-operative morbidity and mortality. Any strategy to reduce blood loss during hepatectomy is important and various surgical and anaesthetic methods have been reported. Although low central venous pressure technique can still be effective, it may not be advantageous concerning the safety of healthy donors undergoing hepatectomy. Emerging evidence suggests that stroke volume variation, a simple and useful index for fluid responsiveness and preload status in various clinical situations, can be applied as a guide for fluid management to reduce blood loss during living donor hepatectomy. Most hemodynamic monitors used widely now are invasive, which may cause complications and bring discomfort to the patients. NICOM is an application of biological reactor technology, monitoring cardiac output, cardiac index, stroke volume, stroke volume variability and other hemodynamic parameters by analysing electric pulses through the frequency change of chest.