Obesity Clinical Trial
Official title:
Intraoperative Goal-directed Fluid Management in Non-Obese and Obese Patients Undergoing Laparoscopic Surgery
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.
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.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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