| The Effects of Continuous Hyperthermic Peritoneal Perfusion (CHPP) on Cardiopulmonary Parameters in the Basis of Systemic Oxygen Balance. |
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Jong Ho Choi, Chang Sung Kim, Tae Hyun Kim, Yoon Ki Lee, Keon Hee Ryu, Nae Yun Yang, Jae Yong Shim, Jeong Hwan Choi |
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Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea. |
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| Abstract |
BACKGROUND
Intra-operative application of continuous hyperthermic peritoneal perfusion (CHPP) in advanced cancer has been introduced as an effective and safe method to lessen the complication and enhance the effectiveness of its treatment. But CHPP induced acute change of body temperature and intra-abdominal pressure would produce various abnormal physiologic response. Now, we investigated to evaluate and understand the trend of changes of cardiac and oxygen parameters during CHPP.
METHODS
Closed peritoneal irrigation was done with perfusate at temperature 47oC for 90 min under general anesthesia. Cardiac and oxygen parameters were measured at 10 min before CHPP, 30, 60, 90 min after the initiation of CHPP, 30 min after the end of CHPP with Swan-Ganz catheter application.
RESULTS
Hemodynamic parameters; Systemic vascular resistance index and mean arterial pressure were decreased trend during CHPP. Pulmonary capillary wedge pressure and cardiac index were increased during CHPP. Oxygen parameters; AaDO2 and shunt fraction were increased during CHPP and O2 index were decreased during CHPP. Oxygen balance; O2 consumption and delivery increased during CHPP.
CONCLUSIONS
We confirmed that systemic oxygen consumption and delivery were increased during CHPP but AaDO2 and shunt fraction were increased which could decrease systemic oxygen delivery. We should need more careful monitoring and proper treatment for maintaining stable hemodynamics and systemic oxygen balance during and after CHPP. |
| Key Words:
Monitoring, hemodynamics, Oxygenation, consumption, transport; Hyperthermia, continuous hyperthermic peritoneal perfusion |
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