Abstract:
:Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is a long and complex procedure with significant blood and fluid loss during debulking and important pathophysiological alterations during the HIPEC phase. We performed a retrospective analysis of 78 consecutive patients undergoing cytoreductive surgery with HIPEC at a university hospital. Our data demonstrate large intra-operative fluid turnover, with 51% of patients requiring a blood transfusion. During HIPEC, airway pressure and central venous pressure increased with a lower oxygenation ratio as a result of increased intra-abdominal pressure with the closed abdomen technique. As a consequence of the raised body temperature, heart rate, end tidal carbon dioxide and arterial lactate levels increased with a slight metabolic acidosis. Peri-operative analysis of routine clotting parameters revealed disturbances of the coagulation status. For pain management, 72% of patients received supplementary thoracic epidural analgesia with consequential peri-operative opioid sparing and a reduced duration of postoperative ventilation.
journal_name
Anaesthesiajournal_title
Anaesthesiaauthors
Schmidt C,Creutzenberg M,Piso P,Hobbhahn J,Bucher Mdoi
10.1111/j.1365-2044.2007.05380.xsubject
Has Abstractpub_date
2008-04-01 00:00:00pages
389-95issue
4eissn
0003-2409issn
1365-2044pii
ANA5380journal_volume
63pub_type
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