Hemodynamic and cardiovascular problems during modified hyperthermic intraperitoneal perioperative chemotherapy.
OBJECTIVE
Cytoreductive surgery and hyperthermic intraperitoneal perioperative chemotherapy (HIPEC) significantly improves patients survival with peritoneal carcinomatosis especially in low-grade tumor e.g. ovarian and appendiceal adenocarcinoma, peritoneal pseudomyxoma and grade I gastric and colorectal cancer.


METHODS
During a period of nine years, hemodynamic and cardiac functions combined with urinary output during hyperthermic intraoperative intraperitoneal chemotherapy were prospectively measured in 60 patients.


RESULTS
Statistically significant hemodynamic and cardiac parameters were characterized by an increased heart rate and cardiac output as well as decreased systemic vascular resistance associated with an increased body temperature and decreased effective circulating volume. The tendency of urinary output was to decrease as the therapy progressed.


CONCLUSIONS
HIPEC induces a hyperdynamic circulatory state requiring increased intravenous fluid administration, which avoids changes because of increased intra-abdominal pressure. Documented by normal blood pressure and adequate urinary output hemodynamic and intravenous fluids, titrated to frequent urinary output determination, can achieve cardiac stability.
Rankovic
Vitomir I
VI
First Surgical University Hospital, Institute for Digestive Diseases, Clinical Center of Serbia, Belgrade, Serbia.
Masirevic
Vesna P
VP
Pavlov
Maja J
MJ
Ceranic
Miljan S
MS
Milenkovic
Marija G
MG
Simic
Aleksandar P
AP
Kecmanovic
Dragutin M
DM
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000502:physiology*; D001810:Blood Volume / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D003131:Combined Modality Therapy; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008297:Male; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D014655:Vascular Resistance / Q000502:physiology
D000970:Antineoplastic Agents