title: Goal-Directed Fluid Therapy on Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients.
abstract: In bariatric surgery, there are no guidelines available for intraoperative fluid administration. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management that has been shown to improve the prognosis of patients undergoing abdominal surgery. The aim of our study is to assess the impact of the implementation of a GDFT protocol in morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG).
  
  
  
  A before-after intervention study, in morbidly obese patients who underwent LSG, was conducted at the Obesity Unit of the General University Hospital Elche. Data from the GDFT implementation group (January 2014 to December 2015) were prospectively collected and compared with a preimplementation group (January 2012 to December 2013).
  
  
  
  Baseline demographic and comorbidity data between the two groups of patients were similar. The length of stay in the hospital was significantly shortened in GDFT group from 4.5 to 3.44 days (p < 0.001). Intraoperative fluid administration was significantly lower in the GDFT group (1002.4 vs 1687.2 ml in preimplementation group, p < 0.001). In the postoperative period, there was a statistically significant reduction in postoperative nausea and vomiting (PONV) after GDFT implementation (48 to 14.3 %, p < 0.001).
  
  
  
  Implementation of GDFT protocols can prevent intraoperative fluid overload in patients undergoing bariatric surgery. It could improve outcomes, for example decreasing PONV or even hospital stay.
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain. jlmunyoz@gmail.com.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Muñoz
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Tanya
authors.initials: T
authors.lastname: Gabaldón
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Miranda
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Diana Lorena
authors.initials: DL
authors.lastname: Berrio
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Ronda
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Esteve
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.affiliation: Hospital General Universitario de Elche, Elche, Alicante, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Pérez
mesh_terms: D000328:Adult; D065187:Controlled Before-After Studies; D005260:Female; D005440:Fluid Therapy; D005743:Gastrectomy / Q000379:methods*; D006040:Goals; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*
keywords: Goal-directed fluid therapy; Sleeve gastrectomy