Volume-challenge in Morbid Obesity
Preoperative venous return stability and euvolemia is essential in management of morbidly obese patients. Fluid therapy regimes for patients with high BMI, especially with focus on preoperative management, are rare and not in consensus.The aim of this study was to evaluate preoperative effects of a standardized, ideal body weight (IBW) based volume-challenge on hemodynamics, stroke volume and level of venous return to the heart.
|Study Design:||Observational Model: Case-Crossover
Time Perspective: Prospective
|Official Title:||Morbid Obesity and Optimization of Preoperative Fluid Therapy|
- level of venous return [ Time Frame: 0,1 hour ] [ Designated as safety issue: No ]
- Volume-responsiveness [ Time Frame: 0,1 hour ] [ Designated as safety issue: No ]
- Evaluation of feasibility of dynamic and non-dynamic echocardiographic indices for volume challenge [ Time Frame: 1 hour ] [ Designated as safety issue: No ]
|Study Start Date:||March 2011|
|Study Completion Date:||April 2013|
|Primary Completion Date:||April 2013 (Final data collection date for primary outcome measure)|
preoperative venous return optimizing
Morbidly obese patients scheduled for bariatric surgery
Other: preoperative venous return optimizing
Preoperative transthoracic echocardiography (TTE) was performed in the awake state before and after volume challenge based on 6ml colloids /kg ideal body weight.
34 morbidly obese patients scheduled for bariatric surgery underwent a preoperative three-week preparation by rapid-weight-loss-diet (RWL) to be accepted for bariatric surgery. Preoperative transthoracic echocardiography (TTE) was performed in the awake state before and after volume-challenge (VC) based on 6ml colloids /kg IBW. Feasibility of standardized VC was evaluated by TTE. Dynamic and non-dynamic echocardiographic indices for VC were studied.
Main outcome measures: Volume-responsiveness and level of venous return before and after volume-challenge were assessed by TTE. An increase of stroke volume ≥ 13% was considered as a volume-responder.