Bariatric Surgery Patients

First Things First (assess & treat for the following)

  • These are not general surgery patients.
  • They have little reserve.
  • They can get very sick, very quickly.
  • Often exhibit very subtle signs and symptoms of serious problems
  • Prepare for challenges with
    • Difficult airways
    • Line access
    • Barriers to diagnostic tests
  • Tachycardia of >120 beats/min for >4 hours means anastomotic leak until proven otherwise in the early postop period.
    • Contact pt’s bariatric surgeon early to obtain history and surgical details.
    • Obtain surgical consult early, preferably surgeon with bariatric surgery experience.
    • The majority of life-threatening postop events will be surgical in nature and must be ruled out first, even if that means re-operation.
    • Most common surgical complications are leak, obstruction and bleeding.
    • Radiologic tests to rule out leaks are only 70% sensitive.
  • These patients are at risk for thiamine deficiency, so give thiamine and MVI prior to glucose.

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Last updated: April 13, 2010