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Volume therapy and cardiocircular function during hyperthermic intraperitoneal chemotherapy.

W Raue¹, N Tsilimparis, A Bloch

¹Department of General, Visceral, Vascular and Thoracic Surgery, Charité University Medicine Berlin, Campus Mitte, Berlin, Germany.

European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes

|October 22, 2009

Summary

This summary is machine-generated.

Large fluid volumes are administered during hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) to maintain circulatory function. HIPEC itself does not increase fluid needs, suggesting potential for optimized fluid management to reduce complications.

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Area of Science:

Surgical Oncology
Critical Care Medicine
Peritoneal Carcinomatosis Management

Background:

Cytoreductive surgery with hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis has high complication rates.
Intraoperative fluid management during HIPEC is not well understood, yet impacts postoperative outcomes.
The balance between liberal and restrictive fluid administration is critical for patient morbidity.

Purpose of the Study:

To detail intraoperative volume replacement strategies during HIPEC.
To assess cardiovascular function throughout the HIPEC procedure.
To investigate fluid administration patterns in patients undergoing cytoreductive surgery and HIPEC.

Main Methods:

Observational trial including 18 consecutive patients undergoing cytoreductive surgery and HIPEC.
Detailed monitoring of intraoperative volume administration.
Assessment of postoperative morbidity and mortality.
Invasive transthoracic thermodilution for cardiofunctional data.

Main Results:

Significant fluid volumes (1,240 ml/h) were administered to maintain circulatory stability.
No hyperdynamic circulatory status was observed during intraoperative intraperitoneal chemotherapy.
Fluid administration was primarily for replacement and circulatory support, not directly driven by HIPEC.

Conclusions:

Substantial fluid volumes are necessary during cytoreductive surgery with HIPEC.
HIPEC itself does not appear to elevate fluid requirements.
Further research into goal-oriented, restricted fluid regimens may reduce postoperative morbidity.