Does preoperative transthoracic echocardiographic assessment predict transanesthetic hemodynamic instability in obese hypertensive patients undergoing bariatric surgery?
Preoperative transthoracic echocardiography may help identify obese hypertensive patients at increased risk of transanesthetic hemodynamic instability during bariatric surgery.
To evaluate whether preoperative transthoracic echocardiography is related to transanesthetic hemodynamic instability in obese hypertensive patients undergoing bariatric surgery. Prospective observational pilot study. Two tertiary care hospitals in Culiacán, Mexico. Adult patients aged 40–60 years with obesity and systemic arterial hypertension scheduled for elective bariatric surgery. Preoperative transthoracic echocardiographic assessment. Hemodynamic instability, defined as changes greater than 30% from baseline blood pressure or heart rate, or the occurrence of arrhythmias during anesthetic induction, maintenance, and extubation. Diastolic dysfunction was observed more frequently with arrhythmias during anesthetic induction and with increases in heart rate greater than 30% during extubation. The presence of at least one echocardiographic abnormality was more frequently observed in patients with hemodynamic instability during induction. Preoperative transthoracic echocardiography may contribute to identifying obese hypertensive patients who could be at increased risk of transanesthetic hemodynamic instability during critical anesthetic periods. These preliminary findings support the potential role of targeted echocardiographic assessment for perioperative risk stratification, although larger studies are needed to confirm these observations.
Martínez-Félix et al. (Wed,) studied this question.