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Preoperative Condition in Giant Obese Patients

Phase 4
Completed
Conditions
Bariatric Surgery Candidate
Morbid Obesity
Interventions
Other: Aminosteril hepa 8%
Dietary Supplement: Caloric diet with 1000 kcal
Registration Number
NCT02616003
Lead Sponsor
Sana Klinikum Offenbach
Brief Summary

The frequency of super-super obese who need immediate weight loss surgery is risen continuously. For those patients a prior-to-surgery conditioning therapy is mandatory to gain technical and physical operability. The exclusively well-established preliminary therapy so far was the intragastric balloon, which takes 7 months of treatment time. Due to life-threatening conditions of giant obese patients, who have been admitted to hospital, the investigators were forced to develop a more prompt acting conditioning therapy to bring those individuals in a short run to an improved and "fit-for-surgery" state. In such an impasse the investigators combine Liraglutide with its well-known weight-loss effect with a leucine-based amino acid infusion that is generally used for patients with liver insufficiency, in expectance of an additional weight loss and liver reduction effect.

Detailed Description

The investigators will use a commercial available amino acid infusion (Aminosteril hepa 8%, Fresenius Karbi), which is used in clinical application for liver conditioning. It is mainly based on the branched-chained amino acid leucine (13.09 g per 1000 ml). The investigators will combine this with a daily subcutaneous injection of Liraglutide. Liraglutide is a GLP-1 analogue, which achieved meanwhile the FDA approval for weight loss treatment. Initial Liraglutide dosage is 1.2 mg for three days, boosted to 1.8 mg consecutively. Participants receive energy reduced nutrition with 1000 kcal/d.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • multimorbid, super-super obese patients
Exclusion Criteria
  • renal insufficiency III

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Super-super Obese PatientsCaloric diet with 1000 kcalMultimorbid, super-super obese patients that need preoperative conditioning therapy (intervention 1: Liraglutide, intervention 2: aminosteril hepa 8%, intervention 3: Caloric diet with 1000 kcal) for weight loss surgery to achieve technical operability.
Super-super Obese PatientsAminosteril hepa 8%Multimorbid, super-super obese patients that need preoperative conditioning therapy (intervention 1: Liraglutide, intervention 2: aminosteril hepa 8%, intervention 3: Caloric diet with 1000 kcal) for weight loss surgery to achieve technical operability.
Super-super Obese PatientsLiraglutideMultimorbid, super-super obese patients that need preoperative conditioning therapy (intervention 1: Liraglutide, intervention 2: aminosteril hepa 8%, intervention 3: Caloric diet with 1000 kcal) for weight loss surgery to achieve technical operability.
Primary Outcome Measures
NameTimeMethod
Operability21 days

Operability means that weight loss surgery could be performed after preoperative condition (due to less visceral fat, less liver volume)

Secondary Outcome Measures
NameTimeMethod
Total Protein in g/l21 days
Albumin in g/l21 days
Chronic inflammation21 days

Changing in CRP in g/l during intervention

Chronic inflammation II21 days

Changing in white blood cell count /nl during intervention

Liver volume21 days

Changing of liver volume during intervention measured by ultrasound

Liver function21 days

Changing of GOT in U/l, GPT in U/l, GGT in U/l and AP in U/l

Pulmonary function21 days

Changing in FEV1 in lung function testing during intervention

Hg A1c in %21 days
Preoperative excess weight loss in %21 days

Trial Locations

Locations (1)

Sana Klinikum Offenbach

🇩🇪

Offenbach, Hessen, Germany

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