Volume-challenge in Morbid Obesity

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Morbid Obesity and Optimization of Preoperative Fluid Therapy

Conditions
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Anomaly; Venous Return

Intervention / Treatment
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* Other: preoperative venous return optimizing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: enrolled for bariatric surgery BMI ≥ 40 or ≥ 35kg/m2 with co-morbidities preoperative three-weeks preparation by rapid-weight-loss-diet and weight loss Exclusion Criteria: untreated significant hypertension unstable angina pectoris significant valve regurgitation or stenosis known severe pulmonary disease

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| preoperative venous return optimizing<br>Morbidly obese patients scheduled for bariatric surgery | Other: preoperative venous return optimizing<br>* Preoperative transthoracic echocardiography (TTE) was performed in the awake state before and after volume challenge based on 6ml colloids /kg ideal body weight.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| level of venous return |  | 0,1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Volume-responsiveness |  | 0,1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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morbidly obese patients,, preoperative volume-challenge,, transthoracic echocardiography,, TTE,, rapid weight loss,, venous return,, bariatric surgery,, left ventricular outflow tract,, stroke volume,, diastolic function,, hypervolemia,, hypovolemia