Role of intraoperative fluids on hospital length of stay in laparoscopic bariatric surgery: a retrospective study in 224 consecutive patients

Nossaman, Vaughn E.; Richardson, William; Wooldridge, James; Nossaman, Bobby D.

doi:10.1007/s00464-014-4029-1

Cited by 24 publications

(13 citation statements)

References 36 publications

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“…The same relationship was found in our study; however, a multivariate analysis revealed that it was contributing less to the risk of prolonged LOS. Nossaman et al concluded that the volume of intravenous fluids administered during laparoscopic bariatric surgery significantly correlates to LOS and delays wound healing [ 37 ]. They showed that lower volumes of intraoperative fluid were significantly associated with longer LOS [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nossaman et al concluded that the volume of intravenous fluids administered during laparoscopic bariatric surgery significantly correlates to LOS and delays wound healing [ 37 ]. They showed that lower volumes of intraoperative fluid were significantly associated with longer LOS [ 37 ]. Contrary to that, we observed that patients who required larger amounts of intraoperative i.v.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Major

Wysocki

Torbicz³

et al. 2017

OBES SURG

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BackgroundLaparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions.MethodsThe study was a prospective observation with a post-hoc analysis of bariatric patients in a tertiary referral university teaching hospital. Inclusion criteria were undergoing laparoscopic bariatric surgery. Exclusion criteria were occurrence of perioperative complications, prior bariatric procedures, and lack of necessary data. The primary endpoints were the evaluations of risk factors for prolonged LOS and readmissions.ResultsMedian LOS was 3 (2–4) days. LOS > 3 days occurred in 145 (29.47%) patients, 79 after LSG (25.82%) and 66 after LRYGB (35.48%; p = 0.008). Factors significantly prolonging LOS were low oral fluid intake, high intravenous volume of fluids administered on POD0, and every additional 50 km distance from habitual residence to bariatric center. The risk of hospital readmission rises with occurrence of intraoperative adverse events and low oral fluid intake on the day of surgery on.ConclusionsRisk factors for prolonged LOS are low oral fluid intake, high intravenous volume of fluids administered on POD0, and every additional 50 km distance from habitual residence. Risk factors for hospital readmission are intraoperative adverse events and low oral fluid intake on the day of surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Major

Wysocki

Torbicz³

et al. 2017

OBES SURG

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“…При забезпеченні радикальної цист-ектомії в 166 хворих P. Wuethrich (2014) застосував інфузію зі швидкістю 3 мл/кг/год із утриманням су-динного тонусу норадреналіном у дозі 2 мкг/кг/год, яку протиставив інфузії зі швидкістю 6 мл/кг/год без використання вазопресорів [40]. V. Nossaman (2015) взагалі розподілив хворих за групами дуже просто: при рестриктивному режимі рідинної ресус-цитації пацієнти під час лапароскопічних операцій отримували не більше за 1750 мл рідини, а при лібе-ральному -понад 1750 мл [41]. В роботі ж M. Healy (2015), до якої увійшли результати лікування 504 хворих, які перенесли панкреатектомію, проведено аналіз відповідно до ефектів 3 режимів інтраопера-ційного рідинного забезпечення: рестриктивного (< 10 мл/кг/год), стандартного (10-15 мл/кг/год) та ліберального (> 15 мл/кг/год) [42].…”

Section: який режим рідинної ресусцитації можна назвати рестриктивнимunclassified

Проблеми Компенсації Операційної Крововтрати: Стратегії Об’ємної Гемодинамічної Підтримки (Аналітичний Огляд)

Курсов¹,

Biletskyy²,

Lyzogub³

et al. 2022

ЕМ

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Усунення негативних впливів значної інтраопе-раційної крововтрати ще й досі являє серйозну про-блему сучасного анестезіологічного забезпечення та хірургічної техніки. Ще, здавалося б, абсолютно очевидні та прозорі положення рідинної ресусцита-ції в умовах значної крововтрати в останні 8-10 ро-ків інтенсивно переглядаються та знову піддаються ретельному аналізу [1][2][3]. На перший план надання допомоги знову виходить застосування цільної кро-ві та її компонентів [4][5][6]. Особливу увагу приділя-ють вибору режиму заповнення крововтрати (лібе-ральний проти рестриктивного) [7][8][9]. В останніх європейських та американських настановах, що присвячені питанням компенсації періопераційної крововтрати, а також проблемі масивної крововтра-ти, експерти стають на бік прихильників рестрик-тивного режиму інфузійної терапії [10][11][12]. Про-те багато питань викликає застосування тактики малооб'ємної та гіпотензивної рідинної ресусцита-

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“…1) [1]. However, attainment of a recommended 'liberal' intravenous fluid hydration strategy during these procedures with median surgical times of 1.0 [0.9-1.1] hrs is difficult [1]. A post-hoc analysis of the duration of nil per os (NPO) revealed a statistically significant dose-response association on the incidence of eHLOS [1]; with the lowest projected incidence within the 2-5 hr NPO interval (10-12 %, Fig.…”

Section: P023mentioning

confidence: 99%

“…As NPO is associated with a state of compensatory dehydration [2], the primary purpose of this study was to examine the role of a shorter NPO interval (C2 hrs) on the incidence of eHLOS and to establish causality between these variables. Methods: Following IRB approval and established fasting guidelines for adult patients, 168 consecutive bariatric surgeries were analyzed following institution of a revised oral water ad libitum policy on the incidence of eHLOS when compared to the prior data set [1]. Categorical variables were presented as percentages with differences between the groups assessed using Chi-square or Fisher exact tests.…”

Section: P023mentioning

confidence: 99%

2016 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Boston, Massachusetts, USA, 16–19 March 2016

2016

Surg Endosc

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Introduction: Peritoneal insufflation with warm humidified (WH) CO 2 gas has been purported to be a beneficial alternative to standard cold and dry (CD) CO 2 gas for laparoscopic surgery. There is limited data regarding the use of WH CO 2 for minimally invasive colorectal resection (MICR). This randomized study was undertaken to determine the impact of WH vs CD CO 2 on operative and short term clinical results.Methods and Procedures: Demographic, operative, and short term clinical data was collected on MICR patients randomized to receive either WH (body temperature) or CD (room temperature) CO 2 during surgery. Outcomes tracked included postoperative (postop) pain levels (visual analog scale) on POD 1-7, and analgesia requirements on POD 1 and 2. All narcotic totals were converted to morphine equivalents for analysis. Ketorolac and acetaminophen requirements were also assessed. In addition, the following variables were tracked: intraoperative core temperatures, length of stay as well as time to 1st flatus, BM, and tolerance of solids. Results: A total of 101 patients were randomized to WH CO 2 (50) or CD CO 2 (51). With regards to co-morbidities and BMI, the 2 groups were similar except that there were more diabetics in the WH group (p = 0.0267). There were no differences in the indications for surgery or MIS methods used. Of note, the mean CO 2 volume used during MICR was 25.6 % less for the WH vs the CD CO 2 group (p = 0.0435). Postop, the visual analog pain scores were similar between groups, however, on POD 1 and 2, WH patients required less narcotics (p = 0.0010 and p = 0.0319 respectively) and ketorolac (p = 0.0163 and p = 0.0153 respectively) than the CD CO 2 group. No difference in acetaminophen use was noted; also, no differences in complication rates, ileus resolution time, and time to regular diet were noted. Conclusion: This randomized study suggests that the analgesia requirement, a surrogate measure of pain, was significantly less in the WH group on POD 1 and 2 despite the fact that the visual analog scale scores were similar. Perhaps the WH gas decreases the desiccation and loss of parietal peritoneal cells that has been shown to occur after laparoscopy done with CD gas. It is unclear why less CO 2 was required in the WH group; the clinical importance of this finding, if any, is also unclear. Further study regarding WH CO 2 is warranted in light of the pain medication differences.Introduction: With the growing prevalence of patients with amyotrophic lateral sclerosis (ALS) there is a need to describe and analyze the correct perioperative management. ALS is a progressive neurodegenerative disease that has devastating effects to respiratory muscles resulting in respiratory failure death in 80 % of patients. Diaphragm pacing (DP) replaces ventilators in spinal cord injury patients and delays death and tracheostomy in ALS patients. This report outlines the peri-operative outcomes to 90 days for patients in a multicenter pivotal FDA trial of DP in ALS.Methods: The study was conducted under an investigat...

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Role of intraoperative fluids on hospital length of stay in laparoscopic bariatric surgery: a retrospective study in 224 consecutive patients

Abstract: The amount of intravenous fluids administered during laparoscopic bariatric surgery plays a significant role on hLOS and on the incidence of delayed wound healing.

Cited by 24 publications

References 36 publications

Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

Проблеми Компенсації Операційної Крововтрати: Стратегії Об’ємної Гемодинамічної Підтримки (Аналітичний Огляд)

2016 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Boston, Massachusetts, USA, 16–19 March 2016

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