Volume therapy and cardiocircular function during hyperthermic intraperitoneal chemotherapy
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Volume therapy and cardiocircular function during hyperthermic intraperitoneal chemotherapy. / Raue, W; Tsilimparis, N; Bloch, A; Menenakos, C; Hartmann, J.
In: EUR SURG RES, Vol. 43, No. 4, 2009, p. 365-372.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Volume therapy and cardiocircular function during hyperthermic intraperitoneal chemotherapy
AU - Raue, W
AU - Tsilimparis, N
AU - Bloch, A
AU - Menenakos, C
AU - Hartmann, J
N1 - 2009 S. Karger AG, Basel.
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Surgical cytoreduction and simultaneous hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis is afflicted with a high incidence of postoperative complications. The knowledge of intraoperative volume therapy during surgery and chemotherapy is limited. On the other hand, the choice of a 'liberal' or 'restrictive' regimen of fluid administration has a deep impact on the postoperative morbidity. The aim of this observational trial was to report detailed data on volume replacement and cardiocircular function during the HIPEC procedure.METHODS: Eighteen consecutive patients undergoing cytoreductive surgery and HIPEC for peritoneal carcinomatosis were enrolled. The intraoperative volume administration was observed as well as the postoperative morbidity and mortality. Cardiofunctional data were assessed by the invasive transthoracic thermodilution technique.RESULTS: The study showed that large amounts of volume (1,240 ml h(-1); range: 810-1,570 ml h(-1)) are given during the HIPEC procedure to replace fluid loss and maintain a stable circulatory function. Signs of a hyperdynamic status during intraoperative intraperitoneal chemotherapy were not found.CONCLUSIONS: During surgical cytoreduction and simultaneous HIPEC, large amounts of volume were administered. HIPEC in itself did not lead to an increased fluid requirement. Further prospective studies with larger populations are needed to investigate whether goal-oriented therapies and a restricted volume regimen can contribute to decrease the postoperative morbidity.
AB - BACKGROUND: Surgical cytoreduction and simultaneous hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis is afflicted with a high incidence of postoperative complications. The knowledge of intraoperative volume therapy during surgery and chemotherapy is limited. On the other hand, the choice of a 'liberal' or 'restrictive' regimen of fluid administration has a deep impact on the postoperative morbidity. The aim of this observational trial was to report detailed data on volume replacement and cardiocircular function during the HIPEC procedure.METHODS: Eighteen consecutive patients undergoing cytoreductive surgery and HIPEC for peritoneal carcinomatosis were enrolled. The intraoperative volume administration was observed as well as the postoperative morbidity and mortality. Cardiofunctional data were assessed by the invasive transthoracic thermodilution technique.RESULTS: The study showed that large amounts of volume (1,240 ml h(-1); range: 810-1,570 ml h(-1)) are given during the HIPEC procedure to replace fluid loss and maintain a stable circulatory function. Signs of a hyperdynamic status during intraoperative intraperitoneal chemotherapy were not found.CONCLUSIONS: During surgical cytoreduction and simultaneous HIPEC, large amounts of volume were administered. HIPEC in itself did not lead to an increased fluid requirement. Further prospective studies with larger populations are needed to investigate whether goal-oriented therapies and a restricted volume regimen can contribute to decrease the postoperative morbidity.
KW - Aged
KW - Carcinoma/drug therapy
KW - Cardiovascular Physiological Phenomena
KW - Chemotherapy, Cancer, Regional Perfusion/adverse effects
KW - Combined Modality Therapy
KW - Female
KW - Hemodynamics
KW - Humans
KW - Hyperthermia, Induced/adverse effects
KW - Intraoperative Period
KW - Male
KW - Middle Aged
KW - Peritoneal Neoplasms/drug therapy
KW - Postoperative Complications/etiology
KW - Treatment Outcome
KW - Water-Electrolyte Balance
U2 - 10.1159/000248164
DO - 10.1159/000248164
M3 - SCORING: Journal article
C2 - 19844110
VL - 43
SP - 365
EP - 372
JO - EUR SURG RES
JF - EUR SURG RES
SN - 0014-312X
IS - 4
ER -