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Anaesthesiological experiences with whole body hyperthermia
T Kerner1, B Hildebrandt, O Ahlers
1Department of Anaesthesiology and Critical Care Medicine, Charité Medical Center, Virchow Hospital, Humboldt University, D-13344 Berlin, Germany. thoralf.kerner@charite.de
Objective:
In order to investigate the safety of whole body hyperthermia (WBH) within the context of systemic Cancer Multistep Therapy (sCMT) in patients with disseminated malignancies, cardiopulmonary changes and various organ functions were examined.
Methods And Procedures:
Fifty-seven sCMT treatments were performed in 22 patients. WBH with a plateau phase of 1 h at 41.8 degrees C was induced by an IRATHERM 2000 device. Cardiopulmonary parameters were measured at 37, 40, 41.8 and 39 degrees C by use of a pulmonary artery catheter, femoral oxymetry and a radial artery catheter. Organ functions of the liver, kidney, cardiovascular and central nervous system were evaluated before and after treatment.
Results:
Compared with the initial values, significant alterations were found of most cardiopulmonary parameters in the sense of hypercirculation at 41.8 degrees C. With the exception of extra vascular lung water index, all parameters showed a clear tendency towards the pre-treatment levels at 39 degrees C. In eight out of 57 sCMT treatments, reversible organ dysfunctions were observed. Comparison of radial and femoral arterial blood pressure showed significantly different values at 40 and 41.8 degrees C.
Conclusions:
WBH induces cardiovascular stress, but by careful selection of patients and appropriate anaesthesiological monitoring it can be performed safely using general anaesthesia. This enables further evaluation of WBH in multimodal treatment concepts.