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Intraoperative Fluid Management and Bariatric Surgery

Perioperative fluid management is always important. The potential short-term or long-term complications of giving too little fluid during surgery must be balanced with the risks of administering too much. In addition to the amount, the type of fluid (colloid or crystalloid) must also be considered. These concerns are relevant for every surgical patient, but are even more important for the obese patient. Obesity is associated with increases in total and lean body weights, but intracellular, extracellular, and absolute total body water contents are each relatively decreased compared with normal weight subjects. Although both aggressive and restrictive fluid strategies have been advocated, there is sparse evidence to support one approach over another. This review will discuss perioperative fluid management, especially as it pertains to the morbidly obese patient undergoing bariatric surgery.