Document Detail


Hemodynamic and cardiac function parameters during heated intraoperative intraperitoneal chemotherapy using the open "coliseum technique".
MedLine Citation:
PMID:  10819370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heated intraoperative intraperitoneal chemotherapy achieves high peritoneal concentrations with limited systemic absorption and has become an important tool in the management of patients with peritoneal carcinomatosis from low-grade malignancies such as pseudomyxoma peritonei and in selected cases of high-grade tumors such as colon adenocarcinoma. When the closed abdomen technique is used, its perioperative toxicity seems to be related to the hemodynamic and cardiac function changes associated with increased body temperature and increased intra-abdominal pressure. METHODS: Hemodynamic and cardiac function variables during heated intraoperative intraperitoneal chemotherapy, using an open abdomen "coliseum technique," were measured in 15 patients with the use of a noninvasive esophageal Doppler monitor. RESULTS: The hemodynamic and cardiac function changes were characterized by an increased heart rate, increased cardiac output and decreased systemic vascular resistance associated with an increased body temperature, and decreased effective circulating volume with the urinary output tending to decrease as the therapy progressed. CONCLUSION: Heated intraoperative intraperitoneal chemotherapy with the open abdomen coliseum technique induces a hyperdynamic circulatory state with an increased intravenous fluid requirement and avoids changes because of increased intra-abdominal pressure. Hemodynamic and cardiac stability, as documented by normal blood pressure and adequate urinary output, can be achieved by liberal intravenous fluids, titrated to frequent urinary output determination.
Authors:
J Esquivel; F Angulo; R K Bland; A D Stephens; P H Sugarbaker
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgical oncology     Volume:  7     ISSN:  1068-9265     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-08-01     Completed Date:  2000-08-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  296-300     Citation Subset:  IM    
Affiliation:
The Washington Cancer Institute, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Agents / administration & dosage*,  therapeutic use
Combined Modality Therapy
Female
Heart / physiology
Hemodynamics
Hot Temperature
Humans
Infusions, Parenteral / methods*
Intraoperative Period
Male
Middle Aged
Peritoneal Neoplasms / drug therapy*,  surgery*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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