Hemodynamic Changes during Continuous Hyperthermic Intraperitoneal Perfusion for Gastric Cancer Patients with Peritoneal Seeding. |
Yu Mee Lee, Chong Hwa Baek, Sung Lyang Chung |
Department of Anesthesiology, University of Ulsan, Asan Medical Center, Seoul, Korea. |
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Abstract |
BACKGREOUND: Hyperthermia is currently effective treatment against numerous cancer gastric cells' seeding on the peritoneal surface and floating in the cancerous ascites. We evaluated changes in hemodynamics during continuous hyperthermic intraperitoneal perfusion (CHPP) to determine strategies for safer general management during this procedure. METHODS Ten patients with far-advanced gastric cancer were given surgical treatment followed by CHPP with anticancer drug. The body temperature, blood pressure, heart rate, central venous pressure, pulmonary artery pressure, cardiac output, electrolyte and blood gas were measured during pre-CHPP, CHPP and post-CHPP period. RESULTS The blood temperature reached 39.3 +/- 0.4 degrees C(mean SD) during CHPP. Heart rate increased to 104.4 +/- 14.2 bpm and the cardiac index to 5.3 +/- 1.5 l.min 1.m 2 during CHPP. The mean arterial pressure remained stable during the study period. The systemic vascular resistance index decreased to 996.7 +/- 324.0 dynes.s.cm 5.m2. The mixed venous oxygen saturation fell during the first part of the CHPP period. CONCLUSIONS This study suggest that the CHPP with anticancer drug may be safe in humans, provided that appropriate monitoring, cooling and technical support are applied. |
Key Words:
Monitoring: hemodynamics; Hyperthermia: intraperitoneal perfusion; Surgery: gastric cancer |
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