ArticleObesity surgery2013
Rapid weight loss is associated with preoperative hypovolemia in morbidly obese patients.
Article in Obesity surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 19 citations in OpenAlex.
- Eight Days of Water-Only Fasting Promotes Favorable Changes in the Functioning of the Urogenital System of Middle-Aged Healthy Men.Nutrients · 2020Trial
- Very low-carbohydrate ketogenic diet before bariatric surgery: prospective evaluation of a sequential diet.Obesity surgery · 2015Trial
- Perioperative fluid guidance with transthoracic echocardiography and pulse-contour device in morbidly obese patients.Obesity surgery · 2014Trial
- Inferior vena cava collapsibility index: a unique point-of-care ultrasound tool to assess postinduction hypotension?Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Scientific evidence underlying contraindications to the ketogenic diet: An update.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2020Review
- Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss.Clinics (Sao Paulo, Brazil) · 2019Observational
- Morbid obesity and optimization of preoperative fluid therapy.Obesity surgery · 2013Observational
- A Plant-Based Dietary Intervention for Preoperative Glucose Optimization in Diabetic Patients Undergoing Total Joint Arthroplasty.American journal of lifestyle medicineArticle
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 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.
methodsIn 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.
resultsA 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.
conclusionsPreoperative 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.
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