A comparison of global end-diastolic volume (GEDI) and central venous pressure (CVP) as parameter for volumen assessment in patients during major liver resections

Results Mean CVP (8,23 +/3,12 mmHg) was normal, whereas mean GEDI (615,2 +/135,44 mL/m2) was decreased. Thirty-one CVP measurements were elevated despite simultaneous GEDI levels indicating a normal or decreased preload. Sensitivity, specificity, positive predictive value, and negative predictive value of CVP with regard to volume depletion (GEDI < 650) were 6,28 (0-12,77. CI 95%), 100 (97,86-100, CI 95%, 43, 2 (28,99-50,82, CI 95%) respectively. CVP did not correlate to GEDI (r = -0,065, p = 0,32), CI (r = 0,23, p = 0,176) and EVLWI (extravascular lung water index) (r = -0,05, p = 0,49). GEDI significantly correlated to CI (r = -0,24, p < 0,01) and VVS (r = -0,39, p < 0,01). Conclusions Volume depletion according to GEDI was found in more than half the patients. The predictive values of CVP with regard to volume depletion were low GEDI and its changes significantly correlated to CI and its changes, which was not observed for CVP. Therefore, GEDI appears to be more appropriate for volume management during major liver resections with the aim to avoid intraoperative bleeding and transfusion.