Physiologic and hemodynamic changes in patients undergoing open abdominal cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Myoung Hwa Kim, Young Chul Yoo, Sun Joon Bai, Kang-Young Lee, Nayeon Kim, Ki Young Lee, Myoung Hwa Kim, Young Chul Yoo, Sun Joon Bai, Kang-Young Lee, Nayeon Kim, Ki Young Lee

Abstract

Objective: We aimed to determine the physiological and hemodynamic changes in patients who were undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) cytoreductive surgeries.

Methods: This prospective, observational study enrolled 21 patients who were undergoing elective cytoreductive surgery with HIPEC at our hospital over 2 years. We collected vital signs, hemodynamic parameters including global end-diastolic volume index (GEVI) and extravascular lung water index (ELWI) using the VolumeView™ system, and arterial blood gas analysis from all patients. Data were recorded before skin incision (T1); 30 minutes before HIPEC initiation (T2); 30 (T3), 60 (T4), and 90 (T5) minutes after HIPEC initiation; 30 minutes after HIPEC completion (T6); and 10 minutes before surgery completion (T7).

Results: Patients showed an increase in body temperature and cardiac index and a decrease in the systemic vascular resistance index. GEDI was 715.4 (T1) to 809.7 (T6), and ELWI was 6.9 (T1) to 7.3 (T5).

Conclusions: HIPEC increased patients' body temperature and cardiac output and decreased systemic vascular resistance. Although parameters that were extracted from the VolumeView™ system were within their normal ranges, transpulmonary thermodilution approach is helpful in intraoperative hemodynamic management during open abdominal cytoreductive surgery with HIPEC.Trial registry name: ClinicalTrials.govTrial registration number: NCT02325648URL: https://ichgcp.net/clinical-trials-registry/NCT02325648&term.

Keywords: Anesthesia; hemodynamic monitoring; hyperthermic intraperitoneal chemotherapy; open abdominal cytoreductive surgery; physiologic change; transpulmonary thermodilution measurement.

Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

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