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Goal-Directed Fluid Therapy on Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients

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Abstract

Background

In bariatric surgery, there are no guidelines available for intraoperative fluid administration. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management that has been shown to improve the prognosis of patients undergoing abdominal surgery. The aim of our study is to assess the impact of the implementation of a GDFT protocol in morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG).

Methods

A before-after intervention study, in morbidly obese patients who underwent LSG, was conducted at the Obesity Unit of the General University Hospital Elche. Data from the GDFT implementation group (January 2014 to December 2015) were prospectively collected and compared with a preimplementation group (January 2012 to December 2013).

Results

Baseline demographic and comorbidity data between the two groups of patients were similar. The length of stay in the hospital was significantly shortened in GDFT group from 4.5 to 3.44 days (p < 0.001). Intraoperative fluid administration was significantly lower in the GDFT group (1002.4 vs 1687.2 ml in preimplementation group, p < 0.001). In the postoperative period, there was a statistically significant reduction in postoperative nausea and vomiting (PONV) after GDFT implementation (48 to 14.3 %, p < 0.001).

Conclusions

Implementation of GDFT protocols can prevent intraoperative fluid overload in patients undergoing bariatric surgery. It could improve outcomes, for example decreasing PONV or even hospital stay.

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Authors and Affiliations

  1. Hospital General Universitario de Elche, Elche, Alicante, Spain

    José Luis Muñoz, Tanya Gabaldón, Elena Miranda, Diana Lorena Berrio, Jaime Ruiz-Tovar, José María Ronda, Nuria Esteve, Antonio Arroyo & Ana Pérez

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  1. José Luis Muñoz
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  2. Tanya Gabaldón
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  3. Elena Miranda
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  4. Diana Lorena Berrio
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  5. Jaime Ruiz-Tovar
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  6. José María Ronda
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  7. Nuria Esteve
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  8. Antonio Arroyo
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  9. Ana Pérez
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Corresponding author

Correspondence to José Luis Muñoz.

Ethics declarations

The study was approved by the local ethics committee prior to conduction of the study.

Conflict of Interest

All authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Muñoz, J.L., Gabaldón, T., Miranda, E. et al. Goal-Directed Fluid Therapy on Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients. OBES SURG 26, 2648–2653 (2016). https://doi.org/10.1007/s11695-016-2145-9

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  • DOI: https://doi.org/10.1007/s11695-016-2145-9

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