• Idit Matot, Radostina Paskaleva, Luminita Eid, Keren Cohen, Abed Khalaileh, Ram Elazary, and Andrei Keidar.
• Department of Anesthesiology and Intensive Care, Tel Aviv Sourasky Medical Center, 6 Weitzman St, Tel Aviv, Israel. iditm@tasmc.health.gov.il
• Arch Surg. 2012 Mar 1;147(3):228-34.

ObjectiveTo determine whether intraoperative fluid management affects urine output in patients undergoing laparoscopic bariatric operations.DesignRandomized controlled trial.SettingAcademic tertiary referral center.PatientsMorbidly obese patients scheduled to undergo laparoscopic bariatric procedures.InterventionsPatients 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.Main Outcome MeasuresThe primary end point was urine output. Secondary end points were postoperative creatinine serum concentration and complication rate.ResultsSignificantly 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).ConclusionsIn 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.

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