Goal-Directed Therapy in Liver Surgery

This review summarizes the updated literature on goal-directed therapy during liver surgery. It provides guidance for clinicians regarding physiologic concepts and clinical evidence related to fluid and hemodynamic management strategies during and after liver resection.

Open liver resection presents unique anatomic and physiologic challenges for the anesthesiologist. Care must be taken to reduce hemorrhage via control of inflow and outflow of hepatic blood. Resuscitation should be individualized to the patient and primarily utilize balanced crystalloids, blood products, and possibly albumin. Administration of intravenous fluids should be guided by hemodynamic parameters. Minimally invasive liver resection may be beneficial to patients but presents additional considerations for goal-directed therapy.

Goal-directed therapy can be utilized to decrease blood loss and optimize the surgical field during liver resection. This strategy holds promise to improve patient outcomes after liver surgery.