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Hemodynamic variations during thoracic and abdominal stop-flow regional chemotherapy
G Varrassi1, S Guadagni, A Ciccozzi
1Department of Anesthesiology, University of L'Aquila, L'Aquila, Italy.
Summary
Stop-flow regional chemotherapy is safe, causing temporary hemodynamic changes that are reversible. Routine pulmonary artery catheterization is not needed except for high-risk patients.
Area of Science:
- Cardiovascular Physiology
- Oncology
- Anesthesiology
Background:
- Regional chemotherapy with stop-flow techniques involves temporary occlusion of major vessels.
- Understanding hemodynamic alterations during these procedures is crucial for patient safety.
Purpose of the Study:
- To investigate hemodynamic modifications during thoracic and abdominal stop-flow regional chemotherapy.
- To assess the necessity of routine hemodynamic monitoring in these procedures.
Main Methods:
- Thirty patients (ASA II-III) underwent thoracic or abdominal stop-flow chemotherapy.
- Extensive hemodynamic parameters including cardiac output, pressures, and oxygen consumption were continuously monitored.
Main Results:
- Aortic and vena cava occlusion led to reduced cardiac output and stroke volume, with increased central venous and pulmonary pressures.
- These hemodynamic changes were reversible upon reperfusion, with no ECG ST modifications observed.
- Oxygen consumption decreased during occlusion and increased post-reperfusion.
Conclusions:
- Stop-flow regional chemotherapy is a safe procedure with reversible hemodynamic and oxygenation changes.
- Routine pulmonary artery catheterization is generally not required, except for patients with high cardiac risk.