Morbid obesity and perioperative complications

Tsai, Andrea; Schumann, Roman

doi:10.1097/aco.0000000000000279

Cited by 52 publications

(17 citation statements)

References 50 publications

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“…Furthermore, patients with BMI > 30 and < 35 kg/m 2 and type 2 diabetes may be considered for surgical treatment as well due to the beneficial effect on diabetes remission [ 3 ]. In the clinical setting of laparoscopic bariatric surgery, the combination of obesity-related physiological alterations, comorbidities, and the surgical procedure per se including the use of pneumoperitoneum (PP) and extreme changes in patient positioning contribute to an increased risk of perioperative hemodynamic complications [ 4 , 5 ]. Thus, an advanced hemodynamic monitoring beyond measurement of arterial pressure is principally desirable [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative non-invasive versus semi-invasive cardiac index monitoring in patients with bariatric surgery – a prospective observational study

Lorenzen¹,

Pohlmann²,

Hansen³

et al. 2020

BMC Anesthesiol

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Background: In morbidly obese patients undergoing laparoscopic bariatric surgery, the combination of obesityrelated comorbidities, pneumoperitoneum and extreme posture changes constitutes a high risk of perioperative hemodynamic complications. Thus, an advanced hemodynamic monitoring including continuous cardiac index (CI) assessment is desirable. While invasive catheterization may bear technical difficulties, transesophageal echocardiography is contraindicated due to the surgical procedure. Evidence on the clinical reliability of alternative semi-or non-invasive cardiac monitoring devices is limited. The aim was to compare the non-invasive vascular unloading to a semi-invasive pulse contour analysis reference technique for continuous CI measurements in bariatric surgical patients. Methods: This prospective observational study included adult patients scheduled for elective, laparoscopic bariatric surgery after obtained institutional ethics approval and written informed consent. CI measurements were performed using the vascular unloading technique (Nexfin®) and semi-invasive reference method (FloTrac™). At 10 defined measurement time points, the influence of clinically indicated body posture changes, passive leg raising, fluid bolus administration and pneumoperitoneum was evaluated pre-and intraoperatively. Correlation, Bland-Altman and concordance analyses were performed.

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Section: Introductionmentioning

confidence: 99%

Perioperative non-invasive versus semi-invasive cardiac index monitoring in patients with bariatric surgery – a prospective observational study

Lorenzen¹,

Pohlmann²,

Hansen³

et al. 2020

BMC Anesthesiol

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“…Similar to many diseases, risk of metabolic syndrome is also the result of interaction between genes and the surrounding environment (Tsai and Schumann 2015). Since human genotypes have not been changed during several centuries, therefore, environmental factors should be considered the main factor of increasing suffering from metabolic syndrome in recent years (Panizzon et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Ability of dairy fat in inducing metabolic syndrome in rats

et al. 2016

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BackgroundThe risk of heart diseases, diabetes and stroke is increased with higher metabolic risk factors. Models of diseases resulting from high-calorie diets have a significant role in pathophysiologic analysis of metabolic syndrome in rodents; but, these diets are considerably different from each other in various studies and may not be very similar to the metabolic syndrome model in humans. This study sought to make a model close to the disease in humans. 20 five-week old male Wistar rats were randomly assigned to two groups. For one of the groups, a high-calorie diet with 416 calories per 100 g with dairy-based fat was considered and, for another group, a control diet was given for 12 weeks. Weight changes, lipid profile, glucose values, Blood pressure, insulin and HOMA indices, were measured for both groups and weight changes were compared using repeated measures and independent t test; also, serum results were compared using independent t test.ResultsValues of weight, glucose, insulin, lipid profile and blood pressure, except HDL, had a tangible difference between two groups at the end of the study. HOMA-IR, HOMA-B and HOMA-S indicates a significant difference between the two groups after consumption high-energy diet.ConclusionThe present study showed ability of dairy fat in gaining weight, insulin resistance and metabolic syndrome and provided the necessity of paying serious attention to the amount of fat intake from dairy sources.

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“…Fourth, in terms of prophylaxis against VTE and its effectiveness, while some research suggests that there appears to be not enough data to recommend the most effective and safe prophylaxis [ 128 ], recent work has provided updates for clinical practice guidelines for thromboembolic prophylaxis in bariatric patients [ 138 ], as well as other useful information of perioperative complications in morbid obesity [ 58 , 139 ].…”

Section: Resultsmentioning

confidence: 99%

Missing something? A scoping review of venous thromboembolic events and their associations with bariatric surgery. Refining the evidence base

Ansari

El-Ansari

2020

Annals of Medicine and Surgery

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Background Venous thromboembolic events (VTE) post-bariatric surgery (BS) lead to morbidity and mortality. Methods This scoping review assessed whether reported VTE post-BS could be under/over-estimated; suggested a possible number of VTE post-BS; appraised whether VTE are likely to decrease/increase; examined BS as risk/protective factor for VTE; and mapped the gaps, proposing potential solutions. Results VTE appears under-estimated due to: identification/coding of BS and VTE; reporting of exposure (BS); and reporting of outcomes (VTE). The review proposes a hypothetical calculation of VTE post-BS. VTE are unlikely to decrease soon. BS represents risk and protection for VTE. Better appreciation of VTE-BS relationships requires longer-term strategies. Conclusion VTE are underestimated. Actions are required for understanding the VTE-BS relationships to in order to crease VTE by better-informed prevention strategy/ies.

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Morbid obesity and perioperative complications

Cited by 52 publications

References 50 publications

Perioperative non-invasive versus semi-invasive cardiac index monitoring in patients with bariatric surgery – a prospective observational study

Perioperative non-invasive versus semi-invasive cardiac index monitoring in patients with bariatric surgery – a prospective observational study

Ability of dairy fat in inducing metabolic syndrome in rats

Missing something? A scoping review of venous thromboembolic events and their associations with bariatric surgery. Refining the evidence base

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