Currently submitted to: JMIR Research Protocols
Date Submitted: Jul 6, 2026
Open Peer Review Period: Jul 7, 2026 - Sep 1, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Controlled low versus standard central venous pressure during pediatric hepatectomy: Study protocol for a randomized controlled trial
ABSTRACT
Background:
Hepatectomy, a major abdominal surgery, is often associated with a high risk of intraoperative bleeding. Literature on the efficacy and safety of controlled low central venous pressure (CLCVP) strategy in pediatric patients is limited and lacking high-quality randomized controlled trials.
Objective:
This prospective randomized controlled trial has been designed to evaluate whether the CLCVP strategy, compared with conventional CVP management, can significantly reduce intraoperative blood loss without increasing adverse events.
Methods:
This is a single-centered, randomized controlled, parallel-group trial. Using stratified block randomization, pediatric patients (aged between 6 months and 14 years) scheduled for hepatectomy will be allocated to either the intervention or control group. The intervention group will receive anesthesia management targeting a CLCVP ≤ 5 cmH2O, while the control group will be managed according to conventional practice (target CVP 5 - 12 cmH2O). The primary outcome will be intraoperative blood loss normalized to body weight (mL/kg). Secondary outcomes include transfusion requirements (indication and volume), severe cerebral oxygen desaturation episodes, perioperative acute kidney injury, and perioperative blood lactate levels.
Results:
This study is currently ongoing. Patient recruitment commenced on January 28, 2026. Twelve patients have been enrolled to date. Recruitment is projected to be completed by December 8, 2027. Data analysis, manuscript preparation, and submission for publication are expected to take place throughout the last quarter of 2027.
Conclusions:
This trial will provide high-quality evidence on the efficacy and safety of a standardized CLCVP strategy in pediatric hepatectomy. The results may guide perioperative hemodynamic management to reduce blood loss in this vulnerable population. Clinical Trial: https://www.chictr.org.cn/, ChiCTR2600116842. Registered on 15 Jan 2026. https://www.chictr.org.cn/showproj.html?proj=300477
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