Best fluid management for bariatric surgery: Restrictive or liberal
Baris Cankaya
Marmara University, Turkey
: J Liver Disease Transplant
Abstract
Bariatric and metabolic surgery procedures are choice of treatment with an increasing number worldwide. Fluid management is a topic of debate for many years. Restrictive and liberal fluid protocols are under research of clinical trials. Which fluid regime should be the best for bariatric procedures? A low fluid administration may lead to decreased circulating volume, redistribution of plasma, decreased urine output. On the other hand, fluid overload may cause complications as edema, raised central venous pressure, deformation of glycocalyx. There is intestinal edema can lead to impaired tolerance for enteral nutrition. Randomized 48 American Society of Anesthesiologists (ASA) grade 1–3 patients for cholecystectomy operation have been compared with liberal (40 ml/kg) and restricted (15 ml/kg) fluid regime. It has been reported that those receiving liberal therapy had fewer postoperative complications. For a long time, it has been accepted that liberal perioperative intravenous fluid administration was better. There are now more evidence that restricted regimen would be more suitable for fast track colon surgery. Major abdominal surgery has risks, economic results and postoperative complications. Latest RELIEF trial (restrictive versus liberal fluid therapy in major abdominal surgery) has found out preliminary supportive evidence for restrictive regimen for major abdominal surgery. As a conclusion perioperative fluid regimen should be individualized. Fluid regimen plays an important role on hospital length of stay for patients undergoing laparoscopic bariatric surgery.
Biography
Baris Cankaya completed his Graduation at Ankara University Medical Faculty in 2000. He has been working as Anaesthesiology Specialist at Marmara University Training Hospital. He has attended academic meetings, nationally and internationally. His academic interest includes “Microcirculation, fluid therapy, resuscitation, patient safety and perioperative analgesia”. Some of his certificates are: EPLS provider Berlin 2015, NLS provider Athens 2015 and MECOR Level I October 2014. He attended international workshops like ECMO workshop 2015, Leicester and Airway workshop, ICISA 2014, and Tel Aviv
