Hemodynamic effects of orally administered delta-ALA during radical prostatectomy
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Hemodynamic effects of orally administered delta-ALA during radical prostatectomy. / Eichhorn, Volker; März, Alexander; Salomon, Georg; Blanc-Groebe, Irmgard; Reuter, Daniel A; Goetz, Alwin E.
in: WORLD J UROL, Jahrgang 31, Nr. 2, 01.04.2013, S. 371-6.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Hemodynamic effects of orally administered delta-ALA during radical prostatectomy
AU - Eichhorn, Volker
AU - März, Alexander
AU - Salomon, Georg
AU - Blanc-Groebe, Irmgard
AU - Reuter, Daniel A
AU - Goetz, Alwin E
PY - 2013/4/1
Y1 - 2013/4/1
N2 - PURPOSE: We investigated hemodynamics in patients receiving delta-Aminolevulinic acid (delta-ALA) to visualize tumor margins prior to radical retro pubic prostatectomy.PATIENTS: Twenty patients undergoing elective open radical retro pubic prostatectomy (RRP).METHODS: Cohort observational study. Ten patients receiving 20 mg/kg of delta-ALA orally prior to surgery (delta-ALA) and 10 patients undergoing RRP without the application of delta-ALA served as a retrospectively matched cohort (CONTROL).MEASUREMENTS: Changes in heart rate (HR), mean arterial blood pressure (MAP), and functional hemodynamic parameters were assessed by electrocardiogram, non-invasive and invasive blood pressure monitoring plus transcardiopulmonary thermodilution.RESULTS: Patients of both groups did not differ in means of age, body mass index, or ASA classification. During surgery, HR and MAP did not differ significantly between both groups. Also, the amount of IV crystalloids and colloids did not differ significantly. In contrast, the amount of vasopressor necessary to maintain MAP within the target range of 70-90 mmHg was significantly higher in delta-ALA when compared to CONTROL (0.08 ± 0.04 μg/kg/min (delta-ALA) vs. 0.03 ± 0.02 μg/kg/min (CONTROL); P < 0.01). Immediately after surgery, patients of delta-ALA showed a significantly higher heart rate (82 ± 18 min(-1) vs. 67 ± 9 min(-1); P < 0.05) compared to patients of CONTROL. Cardiac index, global end-diastolic volume index, and extravascular lung water index were significantly higher after surgery, when compared to baseline values (P < 0.05).CONCLUSIONS: Orally administered delta-ALA prior to open radical prostatectomy induces hemodynamic instability in the perioperative period requiring vasopressor support. Further, an increase of extravascular lung water points toward an increased vascular permeability induced by delta-ALA.
AB - PURPOSE: We investigated hemodynamics in patients receiving delta-Aminolevulinic acid (delta-ALA) to visualize tumor margins prior to radical retro pubic prostatectomy.PATIENTS: Twenty patients undergoing elective open radical retro pubic prostatectomy (RRP).METHODS: Cohort observational study. Ten patients receiving 20 mg/kg of delta-ALA orally prior to surgery (delta-ALA) and 10 patients undergoing RRP without the application of delta-ALA served as a retrospectively matched cohort (CONTROL).MEASUREMENTS: Changes in heart rate (HR), mean arterial blood pressure (MAP), and functional hemodynamic parameters were assessed by electrocardiogram, non-invasive and invasive blood pressure monitoring plus transcardiopulmonary thermodilution.RESULTS: Patients of both groups did not differ in means of age, body mass index, or ASA classification. During surgery, HR and MAP did not differ significantly between both groups. Also, the amount of IV crystalloids and colloids did not differ significantly. In contrast, the amount of vasopressor necessary to maintain MAP within the target range of 70-90 mmHg was significantly higher in delta-ALA when compared to CONTROL (0.08 ± 0.04 μg/kg/min (delta-ALA) vs. 0.03 ± 0.02 μg/kg/min (CONTROL); P < 0.01). Immediately after surgery, patients of delta-ALA showed a significantly higher heart rate (82 ± 18 min(-1) vs. 67 ± 9 min(-1); P < 0.05) compared to patients of CONTROL. Cardiac index, global end-diastolic volume index, and extravascular lung water index were significantly higher after surgery, when compared to baseline values (P < 0.05).CONCLUSIONS: Orally administered delta-ALA prior to open radical prostatectomy induces hemodynamic instability in the perioperative period requiring vasopressor support. Further, an increase of extravascular lung water points toward an increased vascular permeability induced by delta-ALA.
KW - Administration, Oral
KW - Aged
KW - Aminolevulinic Acid
KW - Arterial Pressure
KW - Case-Control Studies
KW - Cohort Studies
KW - Heart Rate
KW - Hemodynamics
KW - Humans
KW - Hypotension
KW - Male
KW - Middle Aged
KW - Perioperative Period
KW - Photosensitizing Agents
KW - Prostatectomy
KW - Prostatic Neoplasms
KW - Vasoconstrictor Agents
U2 - 10.1007/s00345-011-0788-7
DO - 10.1007/s00345-011-0788-7
M3 - SCORING: Journal article
C2 - 22120180
VL - 31
SP - 371
EP - 376
JO - WORLD J UROL
JF - WORLD J UROL
SN - 0724-4983
IS - 2
ER -