Evidence map›Paper›PMID 40396243›Full record

Trial reportAnnals of surgery2026

Impact of Hypovolemic Phlebotomy With Low Central Venous Pressure on Intraoperative Blood Loss in Open Liver Resection: A Double-Blind Randomized Controlled Trial.

Warangkana Lapisatepun, Anon Chotirosniramit, Sunhawit Junrungsee, Nutthanun Tungsrirut, Kullakanya Maykanggoon, Phuriphong Chanthima, Atipa Nitayamekin, Worakitti Lapisatepun

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Warangkana LapisatepunDepartment of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand.ORCID 0000-0002-1353-5173
Anon ChotirosniramitDepartment of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Faculty of Medicine, Chiang Mai University, Thailand.
Sunhawit JunrungseeDepartment of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Faculty of Medicine, Chiang Mai University, Thailand.ORCID 0000-0002-9126-089
Nutthanun TungsrirutDepartment of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand.
Kullakanya MaykanggoonDepartment of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand.
Phuriphong ChanthimaDepartment of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand.
Atipa NitayamekinDepartment of Anesthesiology, Faculty of Medicine, Chiang Mai University, Thailand.
Worakitti LapisatepunDepartment of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Faculty of Medicine, Chiang Mai University, Thailand.ORCID 0000-0001-9138-4967

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the efficacy and safety of hypovolemic phlebotomy (HP) versus conventional management (control group) in achieving low central venous pressure (CVP) to reduce blood loss during open liver resections.

backgroundExcessive blood loss increases perioperative complications and worsens patient outcomes. HP is used to reduce blood loss and the need for allogenic transfusions. This study compares intraoperative blood loss between HP and conventional techniques in liver resection.

methodsThis prospective, randomized controlled trial, conducted between 2020 and 2024, evaluated intraoperative blood loss as the primary endpoint, with secondary endpoints of allogenic transfusion and postoperative outcomes.

resultsOne hundred participants were randomized to either the HP or control groups, with similar baseline characteristics. The HP group had significantly lower blood loss during parenchymal transection [300 (250-500) vs. 500 (300-750) mL, difference=150, 95% CI: 50-275; P =0.02], shorter time to achieve low CVP [50 (30-100) vs. 107.5 (45-150) minutes, difference=-75.0, 95% CI: -95.0 to -56.0; P = 0.01], and a lower surgical bleeding score [2 (1-3) vs. 2 (2-4), difference=-1.0, 95% CI: -1.0 to -0.5; P =0.01]. Transfusion rates and postoperative complications were similar. HP was an independent protective against blood loss >500 mL (AOR=0.19, 95% CI: 0.04-0.80; P =0.02).

conclusionsHP significantly reduces intraoperative blood loss and enhances bleeding control by achieving a low CVP more quickly. It is an effective technique for minimizing blood loss and improving outcomes in open liver resections.

Indexed as

Blood Loss, SurgicalCentral Venous PressureHepatectomyHypovolemiaPhlebotomyAdultAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedProspective StudiesTreatment Outcomecentral venous pressurehypovolemic phlebotomyintraoperative blood lossopen liver resectionrandomized controlled trial

Identifiers

PMID40396243

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.