title: Effect of the volume of fluids administered on intraoperative oliguria in laparoscopic bariatric surgery: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether intraoperative fluid management affects urine output in patients undergoing laparoscopic bariatric operations.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Academic tertiary referral center.
  
  
  METHODS
  Morbidly obese patients scheduled to undergo laparoscopic bariatric procedures.
  
  
  METHODS
  Patients were randomly assigned to receive intraoperatively high (10 mL/kg/h, n = 55) or low (4 mL/kg/h, n = 52) amounts of Ringer lactate solution.
  
  
  METHODS
  The primary end point was urine output. Secondary end points were postoperative creatinine serum concentration and complication rate.
  
  
  RESULTS
  Significantly more fluids were administered intraoperatively to patients in the high-volume group compared with the low-volume group (P < .001). Regardless of the amount of fluids administered intraoperatively, low urine outputs (median [range], 100 [15-1050] mL in the high-volume group vs 107 [25-500] mL in the low-volume group; P = .34) were documented and were not significantly different. The mean creatinine serum concentration was within normal range at all times and was not significantly different between the groups (P = .68). The number of patients with complications was nonsignificantly lower in the low-volume group compared with the high-volume group (7 vs 10 patients, respectively; P = .60).
  
  
  CONCLUSIONS
  In patients undergoing laparoscopic bariatric surgery, intraoperative urine output is low regardless of the use of relatively high-volume fluid therapy. The results suggest that we should reconsider the common practice to administer intraoperative fluids in response to low urine output. Further studies are required to evaluate these data in other surgical patient populations. Trial Registration  clinicaltrials.gov Identifier: NCT00753402.
authors: Department of Anesthesiology and Intensive Care, Tel Aviv Sourasky Medical Center, 6 Weitzman St, Tel Aviv, Israel. iditm@tasmc.health.gov.il
authors: Idit
authors: I
authors: Matot
authors: Radostina
authors: R
authors: Paskaleva
authors: Luminita
authors: L
authors: Eid
authors: Keren
authors: K
authors: Cohen
authors: Abed
authors: A
authors: Khalaileh
authors: Ram
authors: R
authors: Elazary
authors: Andrei
authors: A
authors: Keidar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000704:Analysis of Variance; D050110:Bariatric Surgery / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D023381:Endpoint Determination; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D007552:Isotonic Solutions / Q000008:administration & dosage*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D009846:Oliguria / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D000077325:Ringer's Lactate; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D003404:Creatinine