Document Detail


Rapid Weight Loss Is Associated with Preoperative Hypovolemia in Morbidly Obese Patients.
MedLine Citation:
PMID:  23086524     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: In morbidly obese patients (MO), adequate levels of venous return (VR) and left ventricular filling pressures (LVFP) are crucial in order to augment perioperative safety. Rapid weight loss (RWL) preparation with very low calorie diet is commonly used aiming to facilitate bariatric surgery. However, the impact of RWL on VR and LVFP is poorly studied. METHODS: In this prospective, controlled, single-center study, we hypothesized that RWL-prepared MO prior to bariatric surgery can be hypovolemic (i.e., low VR) and compared MO to lean controls with conventional overnight fasting. Twenty-eight morbidly obese patients were scheduled consecutively for bariatric surgery and 19 lean individuals (control group, CG) for elective general surgery. Preoperative assessment of VR, LVFP, and biventricular heart function was performed by a transthoracic echocardiography (TTE) protocol to all patients in the awake state. Assessment of VR and LVFP was made by inferior vena cava maximal diameter (IVCmax) and inferior vena cava collapsibility index- (IVCCI) derived right atrial pressure estimations. RESULTS: A majority of MO (71.4 %) were hypovolemic vs. 15.8 % of lean controls (p < 0.001, odds ratio = 13.3). IVCmax was shorter in MO than in CG (p < 0.001). IVCCI was higher in MO (62.1 ± 23 %) vs. controls (42.6 ± 20.8; p < 0.001). Even left atrium anterior-posterior diameter was shorter in MO compared to CG. CONCLUSIONS: Preoperative RWL may induce hypovolemia in morbidly obese patients. Hypovolemia in MO was more common vs. lean controls. TTE is a rapid and feasible tool for assessment of preload even in morbid obesity.
Authors:
Tomi Pösö; Doris Kesek; Roman Aroch; Ola Winsö
Related Documents :
2799864 - Survival after stroke and transient ischemic attacks during the 1970s and 1980s.
8248954 - One-year reduction and longitudinal analysis of carotid intima-media thickness associat...
23297394 - Weight-loss history as a predictor of obesity treatment outcome: prospective, long-term...
19748764 - Redo surgery or carotid stenting for restenosis after carotid endarterectomy: results o...
3763154 - Results of late probing for congenital nasolacrimal duct obstruction.
9394774 - Current fda-approved treatments for helicobacter pylori and the fda approval process.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-21
Journal Detail:
Title:  Obesity surgery     Volume:  -     ISSN:  1708-0428     ISO Abbreviation:  Obes Surg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Surgical and Perioperative Sciences, Umeå University, 90185, Umeå, Sweden, tomi.poso@anestesi.umu.se.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Unconjugated bilirubin restricts oligodendrocyte differentiation and axonal myelination.
Next Document:  Modeling thermoelectric transport in organic materials.