Obesity and Goal-directed Intraoperative Fluid Therapy

NCT ID: NCT01052519

Last Updated: 2014-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2014-06-30

Brief Summary

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The purpose of the study is to compare non-obese patients (BMI≤ 30 kg/m2)versus obese patients (BMI\> 30 kg/m2) in regard of their respective needs for intraoperative fluid therapy during laparoscopic surgery.

Specifically the investigators will test the hypothesis that subcutaneous tissue oxygenation (PsqO2)is increased in obese patients when fluid management is optimized by means of esophageal Doppler monitoring compared to obese patients undergoing standard fluid management.

Furthermore the investigators will test the hypothesis that PsqO2 is decreased in obese patients undergoing conventional fluid therapy compared to non-obese patients when fluid management is optimized. Thus the investigators assume that PsqO2 is similar in obese and non-obese patients when fluid management is optimized in both groups.

Detailed Description

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Hemodynamic stability and normovolemia are critical determinants of tissue perfusion and oxygenation. Adequate tissue oxygenation is essential to maintain normal physiologic functions and to reduce complications, such as wound infections.

Fat tissue is relatively hypoperfused and, therefore, poorly oxygenated. Subcutaneous tissue oxygenation in the obese is thus critically low and even supplemental oxygen only slightly increases subcutaneous oxygenation.It is likely that poor subcutaneous oxygenation in the obese surgical patients results in part from inadequate intraoperative fluid replacement.

It remains unknown how to hydrate obese surgical patients best. The most physiologic approach for perioperative fluid replacement is now thought to be goal-directed management, using stroke volume as the treatment parameter.

Conditions

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Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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obese control

Group Type NO_INTERVENTION

No interventions assigned to this group

obese goal-directed

Group Type ACTIVE_COMPARATOR

Goal directed fluid therapy

Intervention Type OTHER

Fluid will be administered to reach maximal stroke volume during the intraoperative period.

non-obese goal directed

Group Type ACTIVE_COMPARATOR

Goal directed fluid therapy

Intervention Type OTHER

Fluid will be administered to reach maximal stroke volume during the intraoperative period.

Interventions

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Goal directed fluid therapy

Fluid will be administered to reach maximal stroke volume during the intraoperative period.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Non-obese (BMI≤ 30kg/m2) and obese patients (BMI \> 30 kg/m2)
* undergoing laparoscopic elective fundoplication or elective bariatric surgery

Exclusion Criteria

* decompensate heart failure
* documented coronary artery disease
* renal insufficiency
* severe chronic obstructive pulmonary disease
* symptoms of infection or sepsis
* esophageal disease (excepting gastro-esophageal reflux without any other esophageal alteration).
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Vienna

OTHER

Sponsor Role lead

Responsible Party

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Barbara Kabon

PD. MD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Barbara Kabon, MD

Role: PRINCIPAL_INVESTIGATOR

MUW

Locations

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Department of Anesthesiology, Medical University of Vienna

Vienna, , Austria

Site Status

Countries

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Austria

References

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Kabon B, Nagele A, Reddy D, Eagon C, Fleshman JW, Sessler DI, Kurz A. Obesity decreases perioperative tissue oxygenation. Anesthesiology. 2004 Feb;100(2):274-80. doi: 10.1097/00000542-200402000-00015.

Reference Type BACKGROUND
PMID: 14739800 (View on PubMed)

Fleischmann E, Kurz A, Niedermayr M, Schebesta K, Kimberger O, Sessler DI, Kabon B, Prager G. Tissue oxygenation in obese and non-obese patients during laparoscopy. Obes Surg. 2005 Jun-Jul;15(6):813-9. doi: 10.1381/0960892054222867.

Reference Type BACKGROUND
PMID: 15978153 (View on PubMed)

Gan TJ, Soppitt A, Maroof M, el-Moalem H, Robertson KM, Moretti E, Dwane P, Glass PS. Goal-directed intraoperative fluid administration reduces length of hospital stay after major surgery. Anesthesiology. 2002 Oct;97(4):820-6. doi: 10.1097/00000542-200210000-00012.

Reference Type BACKGROUND
PMID: 12357146 (View on PubMed)

Muhlbacher J, Luf F, Zotti O, Herkner H, Fleischmann E, Kabon B. Effect of Intraoperative Goal-Directed Fluid Management on Tissue Oxygen Tension in Obese Patients: a Randomized Controlled Trial. Obes Surg. 2021 Mar;31(3):1129-1138. doi: 10.1007/s11695-020-05106-x. Epub 2020 Nov 27.

Reference Type DERIVED
PMID: 33244655 (View on PubMed)

Other Identifiers

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708/2009, local IRB

Identifier Type: -

Identifier Source: org_study_id