Effects of Liberal Versus Restrictive Fluid Therapy on Renal Function Indices in Laparoscopic Bariatric Surgery

Alimian, Mahzad; Mohseni, Masood; Moghadam, Omid Moradi; Siamdoust, Seyed Alireza Seyed; Moazzami, Javad

doi:10.5812/aapm.95378

Cited by 6 publications

(6 citation statements)

References 20 publications

(19 reference statements)

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“…If fluid therapy is inadequate, complications such as hypotension, acute renal injury, arrhythmia, ischemia, and anastomotic leakage may occur due to hypovolemia. In contrast, complications such as prolonged mechanical ventilation, delayed wound healing, infection, and prolonged discharge time due to hypervolemia may occur after excessive fluid intake [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Dynamic Measures in Intraoperative Goal-Directed Fluid Therapy of Patients with Morbid Obesity Undergoing Laparoscopic Sleeve Gastrectomy

Urhan,

Demirel,

Deniz

et al. 2024

OBES SURG

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Introduction Obesity increases the risk of morbidity and mortality during surgical procedures. Goal-directed fluid therapy (GDFT) is a new concept for perioperative fluid management that has been shown to improve patient prognosis. This study aimed to investigate the role of the Pleth Variability Index (PVI), systolic pressure variation (SPV), and pulse pressure variation (PPV) in maintaining tissue perfusion and renal function during GDFT management in patients undergoing laparoscopic sleeve gastrectomy (LSG). Materials and Methods Two hundred ten patients were enrolled in our prospective randomized controlled clinical trial. Demographic data, hemodynamic parameters, biochemical parameters, the amount of crystalloid and colloid fluid administered intraoperatively, and the technique of goal-directed fluid management used were recorded. Patients were randomly divided into three groups: PVI (n = 70), PPV (n = 70), and SPV (n = 70), according to the technique of goal-directed fluid management. Postoperative nausea and vomiting, time of return of bowel movement, and hospital stay duration were recorded. Results There was no statistically significant difference between the number of crystalloids administered in all three groups. However, the amount of colloid administered was statistically significantly lower in the SPV group than in the PVI group, and there was no significant difference in the other groups. Statistically, there was no significant difference between the groups in plasma lactate, blood urea, and creatinine levels. Conclusion In LSG, dynamic measurement techniques such as PVI, SPV, and PPV can be used in patients with morbid obesity without causing intraoperative and postoperative complications. PVI may be preferred over other invasive methods because it is noninvasive. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Comparison of Dynamic Measures in Intraoperative Goal-Directed Fluid Therapy of Patients with Morbid Obesity Undergoing Laparoscopic Sleeve Gastrectomy

Urhan,

Demirel,

Deniz

et al. 2024

OBES SURG

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“…After entering the operating room, intravenous cannulation, and infusion of 5 cc/kg Ringer's crystalloid solution (22), standard monitoring (ECG-POM-NIBP-EtCO 2 ) was established. Then, the patients were placed in their random respective groups.…”

Section: Methodsmentioning

confidence: 99%

Comparison of RAMP and New Modified RAMP Positioning in Laryngoscopic View During Intubation in Patients with Morbid Obesity: A Randomized Clinical Trial

et al. 2021

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Background: The prevalence of obesity is increasing worldwide, and anesthesiologists are facing challenges in the airway management of such patients. Excessive adipose tissue influences pharyngeal spaces and affects the laryngoscopic grade. Standard ramp positioning is time-consuming and difficult to prepare, and requires expensive equipment. Objectives: The aim of this study was to compare the standard ramp position with the proposed low-cost and easily accessible modified ramp position in laryngoscopic view during the intubation of patients with morbid obesity. Methods: In this single-blind clinical trial, 84 patients candidate for bariatric surgery at Rasoul Akram Hospital in 2020 were assigned to the rapid airway management positioner (RAMP) (R) and new modified RAMP (MR) groups by the block randomization method. The laryngoscopic view of the glottis based on the Cormack-Lehane scale, ventilation quality, duration of intubation, intubation attempts, oxygen saturation at the end of intubation, and the need for backward, upward, rightward pressure (BURP) maneuver for successful intubation were recorded. Normal distribution tests and Mann-Whitney and Kruskal-Wallis tests were used to analyze the data. Results: The results showed no significant differences between the two groups regarding ventilation score, laryngoscopy grade, number of intubation attempts, duration of intubation, and the need for BURP maneuvers during intubation (P > 0.05). Conclusions: The two methods are not significantly different, and the new modified ramp position can be used with more ease and availability and less cost.

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“…[ 49 ] Alimian et al . [ 50 ] have compared liberal vs. restrictive fluid management in bariatric surgeries and showed no difference in the effect of both kinds of fluid management. Still, only one study proved that liberal fluids administration is associated with a lower risk of acute kidney injury.…”

Section: Anesthetic Challengesmentioning

confidence: 99%

Pediatric obesity and anesthetic challenges of metabolic surgery

Hashim

Sedky²,

Masood

et al. 2022

Saudi J Anaesth

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Obesity in the pediatric population is considered a growing problem. It is likely that there will be a significant impact related to obesity on the health of future generations. Obesity has increased the incidence of a spectrum of diseases ranging from microvascular complications over the retina and peripheral nerves to an increased incidence of cancer. We have conducted an electronic search in MEDLINE, PubMed, ISI Web of Science, and Scopus scientific databases targeting studies published between 2000 till 2019. Several modalities have shown a wide spectrum of the effectiveness of weight control among adolescents. Despite achieving short-term success among obese adolescents, maintaining such change is challenging. The emergence of metabolic or bariatric surgeries has opened the door for long-term control over weight gain with considerable remission of unfavorable metabolic mediated or modulated effects associated with obesity such as diabetes mellitus and hypertension. The most commonly practiced metabolic surgery among adolescents is sleeve gastrectomy which is associated with comparable weight and metabolic control and a lesser risk of complication. Anesthesia is considered a major challenge among the pediatric population, especially those with significant obesity. Preoperative evaluation is always warranted to exclude and manage different associated comorbidities. The anesthetic challenges associated with pediatric obesity begin with intubation. Maintenance and emergence from anesthesia along with postoperative antiemetics and analgesia can pose additional challenges. Managing the postoperative period is considered a cornerstone in the early detection and management of any postoperative complication. Especially those complications related to the metabolic and nutritional aspects of the bariatric surgery. Finally, despite being a valuable option in managing obesity, bariatric surgery in adolescents comes with significant anesthetic challenges that need to be consistently evaluated and managed.

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Effects of Liberal Versus Restrictive Fluid Therapy on Renal Function Indices in Laparoscopic Bariatric Surgery

Cited by 6 publications

References 20 publications

Comparison of Dynamic Measures in Intraoperative Goal-Directed Fluid Therapy of Patients with Morbid Obesity Undergoing Laparoscopic Sleeve Gastrectomy

Comparison of Dynamic Measures in Intraoperative Goal-Directed Fluid Therapy of Patients with Morbid Obesity Undergoing Laparoscopic Sleeve Gastrectomy

Comparison of RAMP and New Modified RAMP Positioning in Laryngoscopic View During Intubation in Patients with Morbid Obesity: A Randomized Clinical Trial

Pediatric obesity and anesthetic challenges of metabolic surgery

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